Shoar Saeed, Shalaby Mostafa, Motiwala Afaq, Jneid Hani, Allencherril Joseph
Department of Medicine, University of Maryland Capital Region Health, Largo, MD, USA.
Department of Medicine, Division of Cardiovascular Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX, USA.
Curr Cardiol Rep. 2024 Dec;26(12):1347-1357. doi: 10.1007/s11886-024-02144-0. Epub 2024 Oct 16.
Despite growing evidence supporting the diagnostic utility of coronary computed tomographic angiography (CCTA) for anatomical assessment of coronary artery disease (CAD), its is underutilized in peri-procedural planning especially in the acute setting.
Incorporation of flow reserve measurement techniques into CCTA has expanded its sensitivity and specificity for obstructive disease, and continued improvement in CCTA technology permits more accurate cross-sectional plaque characterization. CCTA has the potential to constitute the mainstay of pre-procedural planning for patients with CAD, who are being considered for percutaneous coronary intervention , reducing their ad hoc nature while facilitating equipment selection and improving catheterization lab safety and throughput. Future studies are needed to compare the cost and benefits of more frequent use of routine pre-procedural CCTA prior to coronary angiography and intervention.
尽管越来越多的证据支持冠状动脉计算机断层血管造影(CCTA)在冠状动脉疾病(CAD)解剖评估中的诊断效用,但在围手术期规划中,尤其是在急性情况下,其未得到充分利用。
将血流储备测量技术纳入CCTA扩大了其对阻塞性疾病的敏感性和特异性,并且CCTA技术的持续改进允许更准确的横截面斑块特征描述。对于正在考虑进行经皮冠状动脉介入治疗的CAD患者,CCTA有可能成为术前规划的主要手段,减少其临时性质,同时便于设备选择并提高导管室的安全性和通量。需要未来的研究来比较在冠状动脉造影和介入治疗之前更频繁地使用常规术前CCTA的成本和益处。