Cardiac Computed Tomography in Monitoring Revascularization.
Elisabetta TonetVeronica AmanteaDavide LapollaPaolo AssabbiAlberto BoccadoroMaria Letizia BerloniMarco MicilloFederico MarchiniSerena ChiarelloAlberto CossuGianluca Calogero CampoPublished in: Journal of clinical medicine (2023)
The use of coronary computed tomography angiography (CCTA) in the setting of stable coronary artery disease is highly recommended for low-risk patients. High-risk patients, such as symptomatic subjects with prior revascularization, are suggested to be investigated with noninvasive functional tests or invasive coronary angiography. CCTA is not considered for these patients because of some well-known CCTA artifacts, such as blooming and motion artifacts. However, new technology has allowed us to obtain images with high spatial resolution, overcoming these well-known limitations of CCTA. Furthermore, the introduction of CT-derived fractional flow reserve and stress CT perfusion has made CCTA a comprehensive examination, including anatomical and functional assessments of coronary plaques. Additionally, CCTA allows for plaque characterization, which has become a cornerstone for the optimization of medical therapy, which is not possible with functional tests. Recent evidence has suggested that CCTA could be used with the aim of monitoring revascularization, both after coronary bypass grafts and percutaneous coronary intervention. With this background information, CCTA can also be considered the exam of choice in subjects with a history of revascularization. The availability of a noninvasive anatomic test for patients with previous coronary revascularization and its possible association with functional assessments in a single exam could play a key role in the follow-up management of these subjects, especially considering the rate of false-positive and negative results of noninvasive functional tests. The present review summarizes the main evidence about CCTA and coronary artery bypass grafts, complex percutaneous coronary intervention, and bioresorbable stent implantation.
Keyphrases
- percutaneous coronary intervention
- coronary artery disease
- coronary artery bypass grafting
- end stage renal disease
- computed tomography
- st segment elevation myocardial infarction
- acute myocardial infarction
- coronary artery
- st elevation myocardial infarction
- antiplatelet therapy
- coronary artery bypass
- newly diagnosed
- acute coronary syndrome
- peritoneal dialysis
- cardiovascular events
- stem cells
- heart failure
- contrast enhanced
- healthcare
- positron emission tomography
- atrial fibrillation
- prognostic factors
- mesenchymal stem cells
- aortic stenosis
- magnetic resonance
- bone marrow
- patient reported outcomes
- dual energy
- convolutional neural network
- pet ct
- smoking cessation
- heat stress