Non‐invasive procedural planning using computed tomography‐derived fractional flow reserve

Autor: Ruben W. de Winter, Henk Everaars, Pepijn A. van Diemen, Paul Knaapen, Charles A. Taylor, Niels J.W. Verouden, Peter M. van de Ven, Roel S. Driessen, Stefan P. Schumacher, M P Opolski, Alexander Nap, Michiel J. Bom, Jonathon Leipsic, Albert C. van Rossum, Ralf Sprengers, Ibrahim Danad
Přispěvatelé: Cardiology, ACS - Atherosclerosis & ischemic syndromes, Radiology and nuclear medicine, ACS - Heart failure & arrhythmias
Rok vydání: 2020
Předmět:
medicine.medical_specialty
Computed Tomography Angiography
medicine.medical_treatment
Computed tomography
Coronary Artery Disease
Fractional flow reserve
030204 cardiovascular system & hematology
Coronary Angiography
Original Studies
Coronary artery disease
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Predictive Value of Tests
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
030212 general & internal medicine
fractional flow reserve
medicine.diagnostic_test
business.industry
Non invasive
Coronary Stenosis
Percutaneous coronary intervention
Coronary ct angiography
General Medicine
computed tomography derived fractional flow reserve
medicine.disease
Coronary Vessels
Fractional Flow Reserve
Myocardial
Invasive coronary angiography
Treatment Outcome
surgical procedures
operative
Conventional PCI
Cardiology
coronary computed tomography angiography
Tomography
X-Ray Computed
Cardiology and Cardiovascular Medicine
business
Zdroj: Bom, M J, Schumacher, S P, Driessen, R S, van Diemen, P A, Everaars, H, de Winter, R W, van de Ven, P M, van Rossum, A C, Sprengers, R W, Verouden, N J W, Nap, A, Opolski, M P, Leipsic, J A, Danad, I, Taylor, C A & Knaapen, P 2021, ' Non-invasive procedural planning using computed tomography-derived fractional flow reserve ', Catheterization and Cardiovascular Interventions, vol. 97, no. 4, pp. 614-622 . https://doi.org/10.1002/ccd.29210
Catheterization and Cardiovascular Interventions
Catheterization and Cardiovascular Interventions, 97(4), 614-622. Wiley-Liss Inc.
ISSN: 1522-726X
1522-1946
DOI: 10.1002/ccd.29210
Popis: Objectives: This study aimed to investigate the performance of computed tomography derived fractional flow reserve based interactive planner (FFRCT planner) to predict the physiological benefits of percutaneous coronary intervention (PCI) as defined by invasive post-PCI FFR. Background: Advances in FFRCT technology have enabled the simulation of hyperemic pressure changes after virtual removal of stenoses. Methods: In 56 patients (63 vessels) invasive FFR measurements before and after PCI were obtained and FFRCT was calculated using pre-PCI coronary CT angiography. Subsequently, FFRCT and invasive coronary angiography models were aligned allowing virtual removal of coronary stenoses on pre-PCI FFRCT models in the same locations as PCI was performed. Relationships between invasive FFR and FFRCT, between post-PCI FFR and FFRCT planner, and between delta FFR and delta FFRCT were evaluated. Results: Pre PCI, invasive FFR was 0.65 ± 0.12 and FFRCT was 0.64 ± 0.13 (p =.34) with a mean difference of 0.015 (95% CI: −0.23–0.26). Post-PCI invasive FFR was 0.89 ± 0.07 and FFRCT planner was 0.85 ± 0.07 (p CT were 0.23 ± 0.12 and 0.21 ± 0.12 (p =.09) with a mean difference of 0.025 (95% CI: −0.20–0.25). Significant correlations were found between pre-PCI FFR and FFRCT (r = 0.53, p CT planner (r = 0.41, p =.001), and between delta FFR and delta FFRCT (r = 0.57, p CT planner tool demonstrated significant albeit modest agreement with post-PCI FFR and change in FFR values after PCI. The FFRCT planner tool may hold promise for PCI procedural planning; however, improvement in technology is warranted before clinical application.
Databáze: OpenAIRE
Externí odkaz: