冠状动脉CT血管造影术指导经皮冠状动脉介入治疗的临床效用：对P4研究者的一项调查
Clinical utility of coronary CT angiography to guide PCI: a survey among P4 investigators.
作者信息
Stalikas Nikolaos, Bouisset Frederic, Mizukami Takuya, Tajima Atomu, Munhoz Daniel, Ikeda Kazumaza, Sonck Jeroen, Wyffels Eric, Wilgenhof Adriaan, Astudillo Patricio, Trabattoni Daniela, Montorsi Piero, Zivelonghi Carlo, Agostoni Pierfranscesco, Scott Benjamin, Vermeersch Paul, Gallinoro Emanuele, Monizzi Giovanni, Andreini Daniele, Vandeloo Bert, Lochy Stijn, Argacha Jean-Francois, Støttrup Nicolaj Brejnholt, Maeng Michael, Engstrøm Thomas, Arslani Ketina, Olsen Niels Thue, Ando Hirohiko, Amano Tetsuya, Ohashi Hirofumi, Jeremias Allen, Ali Ziad, Shlofmitz Evan, Sakai Koshiro, Spratt James C, Brilakis Emmanouil S, Sandoval Yader, Stefanini Giulio, Bagnall Alan, Purcell Ian, Edes István Ferenc, De Bruyne Bernard, Collet Carlos
机构信息
Departmentof Cardiology, Cardiovascular Center OLV Hospital, Moorselbaan, Aalst, 1654, B-9300, Belgium.
Toulouse University Hospital, Toulouse, France.
出版信息
Int J Cardiovasc Imaging. 2025 Feb 19. doi: 10.1007/s10554-025-03323-y.
BACKGROUND
Coronary CT Angiography (CTA) is increasingly being used to plan percutaneous coronary intervention (PCI), offering detailed pre-procedural anatomical and physiological insights. The Precise Procedural and PCI Plan (P4) study evaluates the efficacy of CT- versus intravascular ultrasound-guided PCI. The aim of this study was to assess the utility of various CT-guided PCI tools and strategies as perceived by experienced operators within the context of the P4 study.
METHODS
A cross-sectional survey was conducted among 25 operators who participate in the P4 trial from multiple international centers. Participants were asked to evaluate the utility of pre-procedural CTA planning, physiological information with virtual PCI, and online guidance. The survey included multiple-choice, Likert scale, and ranking questions.
RESULTS
Most respondents valued pre-procedural planning highly (average score 2.83/3), particularly for the assessment of plaque composition and calcium characterization. Plaque composition evaluation, including calcium analysis, was ranked as the most valued factor, with an average usefulness score of 6.13/7. Calcium arc information was rated as the most useful component of calcium analysis (4/5 rating). The survey highlighted the importance of myocardial mass at risk assessment in bifurcation PCI and pointed to the anticipation of calcium density as a key future aspect of CT-guided PCI procedures.
CONCLUSIONS
The integration of CT-guided PCI promises to refine procedural planning and to pave the way for a new standard of care in patients with stable CAD.
背景
冠状动脉CT血管造影（CTA）越来越多地用于规划经皮冠状动脉介入治疗（PCI），可提供详细的术前解剖和生理信息。精准手术与PCI计划（P4）研究评估了CT引导与血管内超声引导PCI的疗效。本研究的目的是在P4研究的背景下，评估经验丰富的操作人员对各种CT引导PCI工具和策略的实用性看法。
方法
对来自多个国际中心参与P4试验的25名操作人员进行了横断面调查。参与者被要求评估术前CTA规划、虚拟PCI的生理信息和在线指导的实用性。调查包括多项选择题、李克特量表和排序问题。
结果
大多数受访者高度重视术前规划（平均得分2.83/3），特别是对于斑块成分评估和钙化特征分析。包括钙化分析在内的斑块成分评估被列为最有价值的因素，平均有用性得分为6.13/7。钙化弧信息被评为钙化分析中最有用的组成部分（评分4/5）。调查强调了在分叉病变PCI中评估心肌危险质量的重要性，并指出预测钙密度是CT引导PCI手术未来的一个关键方面。
结论
CT引导PCI的整合有望优化手术规划，并为稳定型CAD患者的新护理标准铺平道路。
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