TY - JOUR
T1 - Pre-procedural planning of coronary revascularization by cardiac computed tomography
T2 - An expert consensus document of the Society of Cardiovascular Computed Tomography
AU - Andreini, Daniele
AU - Collet, Carlos
AU - Leipsic, Jonathon
AU - Nieman, Koen
AU - Bittencurt, Marcio
AU - de Mey, Johan
AU - Buls, Nico
AU - Onuma, Yoshinobu
AU - Mushtaq, Saima
AU - Conte, Edoardo
AU - Bartorelli, Antonio L.
AU - Stefanini, Giulio
AU - Sonck, Jeroen
AU - Knaapen, Paul
AU - Ghoshhajra, Brian
AU - Serruys, Patrick W.
N1 - Funding Information: Carlos Collet reports receiving Consultant/Honoraria: Abbott Vascular, HeartFlow, Siemens and Grants/research support: Abbott Vascular , HeartFlow, Siemens . Patrick Serruys reports consultancy fees from Abbott, Biosensors, Medtronic, Micell, Qualimed, Sinomedical Sciences, St. Jude Medical, Stentys, Svelte Medical Systems, Philips/Volcano, Xeltis, StentIt and HeartFlow. Koen Nieman reports unrestricted institutional research support from Siemens Healthineers, HeartFlow Inc, Bayer. Marcio Bittencourt reports Consultant/Honoraria: Bayer, Research funding: Sanofi and Speaker's bureau: NovoNordisk, EMS, Novartis, GE Healthcare. Jonathon Leipsic reports Consultant/Honoraria: Circle CVI, HeartFlow, MVRX; Grants/Research Support: Abbott , Boston Scientific, GE Healthcare , Edwards , Medtronic ; Speaker's Bureau: Philips; Stock and stock options: HeartFlow, Circle CVI. Giulio Stefanini reports research grant (to the Institution) from Boston Scientific , and speaker fees Abbott Vascular and Boston Scientific. Funding Information: Carlos Collet reports receiving Consultant/Honoraria: Abbott Vascular, HeartFlow, Siemens and Grants/research support: Abbott Vascular, HeartFlow, Siemens. Patrick Serruys reports consultancy fees from Abbott, Biosensors, Medtronic, Micell, Qualimed, Sinomedical Sciences, St. Jude Medical, Stentys, Svelte Medical Systems, Philips/Volcano, Xeltis, StentIt and HeartFlow. Koen Nieman reports unrestricted institutional research support from Siemens Healthineers, HeartFlow Inc, Bayer. Marcio Bittencourt reports Consultant/Honoraria: Bayer, Research funding: Sanofi and Speaker's bureau: NovoNordisk, EMS, Novartis, GE Healthcare. Jonathon Leipsic reports Consultant/Honoraria: Circle CVI, HeartFlow, MVRX; Grants/Research Support: Abbott, Boston Scientific, GE Healthcare, Edwards, Medtronic; Speaker's Bureau: Philips; Stock and stock options: HeartFlow, Circle CVI. Giulio Stefanini reports research grant (to the Institution) from Boston Scientific, and speaker fees Abbott Vascular and Boston Scientific. Publisher Copyright: © 2022 Society of Cardiovascular Computed Tomography
PY - 2022/12/2
Y1 - 2022/12/2
N2 - Coronary CT angiography (CCTA) demonstrated high diagnostic accuracy for detecting coronary artery disease (CAD) and a key role in the management of patients with low-to-intermediate pretest likelihood of CAD. However, the clinical information provided by this noninvasive method is still regarded insufficient in patients with diffuse and complex CAD and for planning percutaneous coronary intervention (PCI) and surgical revascularization procedures. On the other hand, technology advancements have recently shown to improve CCTA diagnostic accuracy in patients with diffuse and calcific stenoses. Moreover, stress CT myocardial perfusion imaging (CT-MPI) and fractional flow reserve derived from CCTA (CT-FFR) have been introduced in clinical practice as new tools for evaluating the functional relevance of coronary stenoses, with the possibility to overcome the main CCTA drawback, i.e. anatomical assessment only. The potential value of CCTA to plan and guide interventional procedures lies in the wide range of information it can provide: a) detailed evaluation of plaque extension, volume and composition; b) prediction of procedural success of CTO PCI using scores derived from CCTA; c) identification of coronary lesions requiring additional techniques (e.g., atherectomy and lithotripsy) to improve stent implantation success by assessing calcium score and calcific plaque distribution; d) assessment of CCTA-derived Syntax Score and Syntax Score II, which allows to select the mode of revascularization (PCI or CABG) in patients with complex and multivessel CAD. The aim of this Consensus Document is to review and discuss the available data supporting the role of CCTA, CT-FFR and stress CT-MPI in the preprocedural and possibly intraprocedural planning and guidance of myocardial revascularization interventions.
AB - Coronary CT angiography (CCTA) demonstrated high diagnostic accuracy for detecting coronary artery disease (CAD) and a key role in the management of patients with low-to-intermediate pretest likelihood of CAD. However, the clinical information provided by this noninvasive method is still regarded insufficient in patients with diffuse and complex CAD and for planning percutaneous coronary intervention (PCI) and surgical revascularization procedures. On the other hand, technology advancements have recently shown to improve CCTA diagnostic accuracy in patients with diffuse and calcific stenoses. Moreover, stress CT myocardial perfusion imaging (CT-MPI) and fractional flow reserve derived from CCTA (CT-FFR) have been introduced in clinical practice as new tools for evaluating the functional relevance of coronary stenoses, with the possibility to overcome the main CCTA drawback, i.e. anatomical assessment only. The potential value of CCTA to plan and guide interventional procedures lies in the wide range of information it can provide: a) detailed evaluation of plaque extension, volume and composition; b) prediction of procedural success of CTO PCI using scores derived from CCTA; c) identification of coronary lesions requiring additional techniques (e.g., atherectomy and lithotripsy) to improve stent implantation success by assessing calcium score and calcific plaque distribution; d) assessment of CCTA-derived Syntax Score and Syntax Score II, which allows to select the mode of revascularization (PCI or CABG) in patients with complex and multivessel CAD. The aim of this Consensus Document is to review and discuss the available data supporting the role of CCTA, CT-FFR and stress CT-MPI in the preprocedural and possibly intraprocedural planning and guidance of myocardial revascularization interventions.
KW - CT-FFR
KW - Coronary CT angiography
KW - Coronary revascularization
KW - Myocardial CT perfusion
KW - Pre-procedural planning
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85139688868&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/35994043
U2 - https://doi.org/10.1016/j.jcct.2022.08.003
DO - https://doi.org/10.1016/j.jcct.2022.08.003
M3 - Article
C2 - 35994043
SN - 1774-024X
VL - 18
SP - e872-e887
JO - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
JF - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
IS - 11
ER -