scholarly journals CT-Coronary Angiography

2019 ◽  
Vol 10 (SPL1) ◽  
Author(s):  
Yussri Jemenin
Keyword(s):  
Chest Pain ◽  
Coronary Angiography ◽  
Large Body ◽  
Invasive Procedure ◽  
Arterial Disease ◽  
Ct Coronary Angiography ◽  
Conventional Coronary Angiography ◽  
Conventional Angiography ◽  
Coronary Arterial Disease ◽  
Non Invasive

A large body of literature has demonstrated the ability of coronary computed tomographic (CT) angiography to rule out significant stenosis. This test is a non-invasive alternative to conventional cardiac angiography in the work-up of patients suspected of having coronary artery disease (CAD) and increasingly as an option for the people. A multi-slices Computed Tomography (CT) is able to perform coronary angiography with very fast scanning time within a few seconds. It is an imaging test tool to detect cardiovascular disease in the arteries that supply blood to the heart. It can be used to diagnose the cause of chest pain or other symptoms. Chest pain can be caused by myocardial infarction that may need immediate investigation and accurate diagnosis before any treatment. The procedure can be done as out-patient, convenient, and with very minimal contrast media (Dye) injection. A CT coronary angiography relies on a powerful X-ray machine with multi-detectors and special computer software to produce 2D and 3D images of the heart and its blood vessels. A conventional coronary angiography is an invasive procedure that requires a flexible tube (catheter) to be threaded through the groin or arm to the heart or coronary arteries. CT coronary angiography is an advantage, non-invasive, and the option for the patient who have contraindicated for conventional angiography. But clinically conventional angiography is still the gold standard for detecting coronary arterial disease.

Diagnostic Performance of CT Coronary Angiography

2016 ◽  
Author(s):  
Christoph I. Lee
Keyword(s):  
Chest Pain ◽  
Coronary Angiography ◽  
Diagnostic Performance ◽  
Ct Coronary Angiography ◽  
Conventional Coronary Angiography ◽  
Clinical Implications ◽  
Clinical Context ◽  
Additional Information ◽  
Study Methodology ◽  
Artery Disease

This chapter, found in the chest pain section of the book, provides a succinct synopsis of a key study examining the diagnostic performance of computed tomography (CT) coronary angiography for patients with chest pain. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. Researchers found that CT angiography accurately detected present and severity of coronary artery disease in certain symptomatic patients, but does not yet replace conventional coronary angiography. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

scholarly journals Downstream testing after CT coronary angiography: time for a rethink?

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001597
Author(s):  
Gareth Morgan-Hughes ◽  
Michelle Claire Williams ◽  
Margaret Loudon ◽  
Carl A Roobottom ◽  
Alice Veitch ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Communication Systems ◽  
Ct Coronary Angiography ◽  
Second Line ◽  
Recent Onset ◽  
Line Test ◽  
Artery Disease

ObjectiveWe surveyed UK practice and compliance with the National Institute for Health and Care Excellence (NICE) ‘recent-onset chest pain’ guidance (Clinical Guideline 95, 2016) as a service quality initiative. We aimed to evaluate the diagnostic utility and efficacy of CT coronary angiography (CTCA), NICE-guided investigation compliance, invasive coronary angiography (ICA) use and revascularisation.MethodsA prospective analysis was conducted in nine UK centres between January 2018 and March 2020. The reporter decided whether the CTCA was diagnostic. Coronary artery disease was recorded with the Coronary Artery Disease–Reporting and Data System (CAD-RADS). Local electronic records and picture archiving/communication systems were used to collect data regarding functional testing, ICA and revascularisation. Duplication of coronary angiography without revascularisation was taken as a surrogate for ICA overuse.Results5293 patients (mean age, 57±12 years; body mass index, 29±6 kg/m²; 50% men) underwent CTCA, with a 96% diagnostic scan rate. 618 (12%) underwent ICA, of which 48% (298/618) did not receive revascularisation. 3886 (73%) had CAD-RADS 0–2, with 1% (35/3886) undergoing ICA, of which 94% (33/35) received ICA as a second-line test. 547 (10%) had CAD-RADS 3, with 23% (125/547) undergoing ICA, of which 88% (110/125) chose ICA as a second-line test, with 26% (33/125) leading to revascularisation. For 552 (10%) CAD-RADS 4 and 91 (2%) CAD-RADS 5 patients, ICA revascularisation rates were 64% (221/345) and 74% (46/62), respectively.ConclusionsWhile CTCA for recent-onset chest pain assessment has been shown to be a robust test, which negates the need for further investigation in three-quarters of patients, subsequent ICA overuse remains with almost half of these procedures not leading to revascularisation.

The Value of Dual-source 64-Slice CT Coronary Angiography in the Assessment of Patients Presenting to an Acute Chest Pain Service

2010 ◽  
Vol 19 (4) ◽  
pp. 213-218 ◽  
Author(s):  
Mark Hansen ◽  
Jonathan Ginns ◽  
Sujith Seneviratne ◽  
Richard Slaughter ◽  
Manuja Premaranthe ◽  
...  
Keyword(s):  
Chest Pain ◽  
Coronary Angiography ◽  
Acute Chest Pain ◽  
Ct Coronary Angiography ◽  
Dual Source

Abstract 220: Magnetic Resonance Imaging in Children with Cardiac Complications of Kawasaki Disease: a Comparison with Echocardiography and Conventional Coronary Angiography

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Michael Khoury ◽  
Cedric Manlhiot ◽  
Lars Grosse-Wortmann ◽  
Shi-Joon Yoo ◽  
Michael Seed ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Imaging Modality ◽  
Artery Bypass ◽  
Cardiac Complications ◽  
Conventional Coronary Angiography ◽  
Non Invasive ◽  
Collateral Artery ◽  
Perfusion Defects ◽  
Imaging Surveillance

Background: MRI is a potentially sensitive, specific, and non-invasive imaging modality that may be used in the detection and monitoring of KD cardiac complications. Its utility relative to the more commonly used imaging modalities of echocardiography and conventional coronary angiography has not been optimally established. Methods: We compared concomitant clinical data, echocardiography, MRI, and angiography findings for children with coronary artery aneurysms. Results: MRI and angiograms were performed within 1 month of each other for 15 patients (mean age 7 years, 80% male) at a mean of 4.2 years after diagnosis. Coronary artery bypass grafting (CABG) had been performed in 8 patients (53%). For 7 patients (47%), aneurysms were seen on MRI that were not seen on echocardiography. Wall motion abnormalities were reported in 7 subjects (47%). These were characterized on both echocardiography and MRI for all. MRI identified perfusion defects in 6 patients (40%) and evidence of myocardial scar in 9 patients (60%). Extra-cardiac aneurysms were identified in 5 patients (33%) on MRI. MRI showed strong correlation with angiograms regarding aneurysm location. MRI was limited in the assessment of bypass grafts in 4 of the 8 (50%) patients who had undergone CABG. Three patients (20%) had stenosis or thrombosis identified on angiography that were not appreciated on MRI. Angiograms provided added information regarding flow, stenoses, vascular morphology and/or calcification in 8 patients (53%). Collateral artery anatomy that was not appreciated on echo and MRI were reported on angiograms in 3 patients (20%). Conclusions: MRI provides a valuable and comprehensive assessment of the cardiac sequelae of KD, though is limited in its assessment of CABG, stenoses, and thrombosis. MRI may be an important component of non-invasive imaging surveillance of children with important coronary artery involvement.

Computerized tomography: coronary angiography and cardiac imaging

2021 ◽  
pp. 224-245
Author(s):  
Jeff M Smit ◽  
Mohammed El Mahdiui ◽  
Michiel A de Graaf ◽  
Arthur JHA Scholte ◽  
Lucia Kroft ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Pulmonary Embolism ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Computerized Tomography ◽  
Acute Chest Pain ◽  
Non Invasive ◽  
Computerized Tomography Angiography ◽  
Artery Disease

Patients presenting with chronic and acute chest pain constitute a common and important diagnostic challenge. This has increased interest in using computerized tomography for non-invasive visualization of coronary artery disease in patients presenting with acute chest pain to the emergency department, particularly the subset of patients who are suspected of having an acute coronary syndrome, but without typical electrocardiographic changes and with normal troponin levels at presentation. As a result of rapid developments in coronary computerized tomography angiography technology, high diagnostic accuracies for excluding coronary artery disease can be obtained. It has been shown that these patients can be discharged safely. The accuracy for detecting a significant coronary artery stenosis is also high, but the presence of coronary artery atherosclerosis or stenosis does not imply necessarily that the cause of the chest pain is related to coronary artery disease. Moreover, non-invasive detection of coronary artery disease by computerized tomography has been shown to be related with an increased use of subsequent invasive coronary angiography and revascularization, and further studies are needed to define which patients benefit from invasive evaluation following coronary computerized tomography angiography. Conversely, implementation of coronary computerized tomography angiography can significantly reduce the length of hospital stay, with a significant cost reduction. Additionally, computerized tomography is an excellent modality in patients whose symptoms suggest other causes of acute chest pain such as aortic aneurysm, aortic dissection, or pulmonary embolism. Furthermore, acquisition of the coronary arteries, thoracic aorta, and pulmonary arteries in a single computerized tomography examination is feasible, allowing ‘triple rule-out’ (exclusion of aortic dissection, pulmonary embolism, and coronary artery disease). Finally, other applications, such as evaluation of coronary artery plaque composition, myocardial function and perfusion, and non-invasive assessment of fractional flow reserve from coronary computerized tomography angiography, are currently being developed and may also become valuable in the setting of chronic and acute chest pain in the future.

scholarly journals Comparison of coronary CT angiography with conventional coronary angiography in the diagnosis of coronary artery disease

2014 ◽  
Vol 40 (1) ◽  
pp. 31-35
Author(s):  
N Mannan ◽  
MA Basher ◽  
J Mohammad ◽  
MU Jahan ◽  
NAM Momenuzzaman ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
High Sensitivity ◽  
Therapeutic Interventions ◽  
Conventional Coronary Angiography ◽  
Promising Alternative ◽  
Non Invasive ◽  
Coronary Ct ◽  
Coronary Imaging ◽  
Artery Disease

Noninvasive CT coronary angiography is a promising coronary imaging technique. In spite of the unprecedented temporal and spatial resolution and the inability to perform therapeutic interventions in the same session multi-detector computed tomography (MDCT) has been considering a promising alternative, non invasive tool for coronary artery imaging due to its high sensitivity and specificity for the detection of significant coronary artery stenosis. To evaluate the diagnostic accuracy of 64-slice MDCT for assessing haemodynamically significant stenoses of the coronary arteries in comparison with the conventional standard cardiac angiography. Fifty patients scheduled for conventional coronary angiography at the department of Radiology and Imaging, United Hospital, Dhaka were enrolled between July 2007 and June 2008. All patients underwent both conventional and MDCT angiography within mean 10.70 days. Overall sensitivity of 64-slice MDCT for the detection of stenosis ?50%, stenosis >50%, and stenosis >75% was 90.0%, 83.8%, and 80.7%, respectively, and specificity was 96.5%, 98.4%, and 98.3% respectively and accuracy was 96.0 %, 96.5%, and 96.6% respectively. Contrast-enhanced 64-slice MDCT allows the identification of coronary stenosis with excellent accuracy. Measurements of stenosis derived by MDCT correlated well with conventional angiogram. A major limitation is the insufficient ability of CT to exactly quantify the degree of stenosis. DOI: http://dx.doi.org/10.3329/bmrcb.v40i1.20334 Bangladesh Med Res Counc Bull 2014; 40: 31-35

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