From the Department of Cardiovascular Medicine, Beaumont Health, Royal Oak, Michigan.
Catheter Cardiovasc Interv. 2019 Feb 1;93(2):298-304. doi: 10.1002/ccd.27817. Epub 2018 Oct 4.
Fractional flow reserve derived by coronary computed tomography angiography (CTA; FFRCT) is an accurate noninvasive method for identifying coronary artery disease (CAD) and detecting hemodynamically significant stenosis. Although initially proposed as noninvasive tools to "rule out" significant CAD in low-risk patients, CTA and FFRCT are now utilized in higher-risk patients. Furthermore, new applications of CTA and FFRCT include a planning tool for percutaneous coronary intervention (PCI), which allows the cardiologist to assess lesion-specific ischemia, plan stent locations and sizes, and use virtual remodeling of the lumen (virtual stenting) to assess the functional impact of PCI. The purpose of this review is to discuss the principles of CTA and FFRCT acquisition, and their application for PCI planning, even before invasive angiography is performed.
通过冠状动脉计算机断层扫描血管造影（CTA；FFRCT）得出的分流量储备是一种识别冠状动脉疾病（CAD）和检测血流动力学意义上的狭窄的准确无创方法。虽然最初被提议作为低危患者中“排除”重大 CAD 的无创工具，但 CTA 和 FFRCT 现在也用于高危患者。此外，CTA 和 FFRCT 的新应用包括经皮冠状动脉介入治疗（PCI）的规划工具，该工具允许心脏病专家评估特定病变的缺血情况、规划支架位置和大小，并使用管腔的虚拟重塑（虚拟支架）来评估 PCI 的功能影响。本综述的目的是讨论 CTA 和 FFRCT 获取的原理及其在 PCI 规划中的应用，甚至在进行有创血管造影之前。
