Hecht Harvey S, Jelnin Vladimir, Roubin Gary S
Lenox Hill Heart and Vascular Institute, 130 E. 77th Street, New York, NY, 10021, USA.
J Invasive Cardiol. 2008 Jan;20(1):1-6.
This study was designed to evaluate the indications for performing multidetector computed tomographic coronary angiography (MDCTA) after catheter-based coronary angiography.
Appropriateness criteria for MDCTA apply exclusively to patient evaluation prior to catheter-based angiography.
All MDCTA performed after catheterbased angiography at a tertiary referral center were reviewed.
Fourteen of a total of 2,000 MDCTAs (0.7%) fulfilled the criteria: 14 were performed after catheter-based angiography. The indications were: 1) inability to selectively cannulate a native vessel or graft; 2) severe pressure damping limiting safe angiography; 3) ostial disease; 4) course of anomalous vessels; 5) relationship of bypass grafts to the sternum; 6) graft morphology; 7) chronic total occlusions. In all cases, the MDCTA enabled definitive treatment.
In a variety of scenarios, MDCT coronary angiography may provide essential information as an adjunctive tool after catheter-based angiography. Indications for MDCTA should be expanded to accommodate these clinical necessities.
本研究旨在评估基于导管的冠状动脉造影术后进行多排螺旋计算机断层扫描冠状动脉造影（MDCTA）的指征。
MDCTA的适用性标准仅适用于基于导管的血管造影术前的患者评估。
回顾了在一家三级转诊中心基于导管的血管造影术后进行的所有MDCTA。
在总共2000例MDCTA中，有14例（0.7%）符合标准：14例是在基于导管的血管造影术后进行的。指征包括：1）无法选择性地插入天然血管或移植物；2）严重的压力衰减限制了安全血管造影；3）开口处病变；4）异常血管的走行；5）旁路移植物与胸骨的关系；6）移植物形态；7）慢性完全闭塞。在所有病例中，MDCTA都有助于明确治疗。
在多种情况下，MDCT冠状动脉造影作为基于导管的血管造影术后的辅助工具，可能提供重要信息。MDCTA的指征应扩大以满足这些临床需求。
