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Planning percutaneous coronary interventions using computed tomography angiography and fractional flow reserve‐derived from computed tomography: A state‐of‐the‐art review
Author(s) -
Feldmann Kyle,
Cami Elvis,
Safian Robert D.
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27817
Subject(s) - medicine , fractional flow reserve , conventional pci , coronary artery disease , radiology , percutaneous coronary intervention , computed tomography angiography , stenosis , stent , percutaneous , cardiology , cad , angiography , lumen (anatomy) , coronary angiography , myocardial infarction , engineering drawing , engineering
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.