The revolution project: replacing coronary artery angiography with coronary computed tomography with functional evaluation
| Autor: | Saima Mushtaq, Antonio L. Bartorelli, Patrick W. Serruys, Daniele Andreini |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Fractional flow reserve
medicine.medical_specialty business.industry medicine.medical_treatment Percutaneous coronary intervention CAD Articles 030204 cardiovascular system & hematology Revascularization medicine.disease Coronary artery disease 03 medical and health sciences Coronary artery bypass surgery Stenosis 0302 clinical medicine medicine Medical imaging Coronary computed tomography angiography AcademicSubjects/MED00200 Stable coronary artery disease 030212 general & internal medicine Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal Supplements : Journal of the European Society of Cardiology |
| ISSN: | 1554-2815 1520-765X |
| Popis: | In the last two decades, several studies and widespread clinical use demonstrated that coronary computed tomography angiography (CCTA) is an appropriate method for the non-invasive assessment of patients with suspected stable coronary artery disease (CAD) and low-to-intermediate pretest likelihood of CAD. Moreover, a growing body of literature is showing that CCTA may have also a clinical role in patients with high pretest likelihood of CAD, known CAD and complex and diffuse disease. Particularly, the SYNTAX II trial demonstrated the feasibility of planning interventional and surgical coronary procedures with CCTA thanks to its ability to combine, in a single method, precise stenosis quantification, accurate plaque characterization, functional assessment with fractional flow reserve derived from standard acquired CCTA datasets, and selection of the revascularization modality for any individual patient and of the vessels that need to be revascularized. More recently, the SYNTAX III Revolution trial showed, in patients with three-vessel CAD with or without left main involvement, that treatment decision-making between percutaneous coronary intervention and coronary artery bypass grafting based on CCTA only has an almost perfect agreement with the treatment decision derived from invasive coronary angiography (ICA). The high degree of correlation between CCTA and ICA suggests the potential feasibility of treatment decision-making based solely on non-invasive imaging and clinical information. New research prospects have opened up for the future to demonstrate the true feasibility and safety of this innovative approach in the clinical arena. |
| Databáze: | OpenAIRE |
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