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Updated: Mar 1, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
CT as gatekeeper of invasive coronary angiography in patients with suspected CAD
1Cardiovascular Center Aalst, Moorselbaan 164, 9300 Aalst, Belgium.
Insights
Cardiac CT scans are a valuable tool for diagnosing heart conditions. They can effectively serve as a "gatekeeper" test, helping to decide which patients need further invasive procedures like coronary angiography.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Cardiac CT is an established diagnostic tool in patient care.
- Various noninvasive functional diagnostic tests exist for similar patient populations.
- Economic constraints necessitate judicious use of diagnostic testing.
Purpose of the Study:
- To evaluate cardiac CT's role as a gatekeeper in diagnostic strategies.
- To determine if cardiac CT can prevent unnecessary invasive procedures.
Main Methods:
- Review of current knowledge on cardiac CT efficacy.
- Analysis of diagnostic testing strategies in cardiology.
Main Results:
- Cardiac CT is a valuable diagnostic tool.
- Cardiac CT has the potential to act as an effective gatekeeper to the cardiac catheterization laboratory (cathlab).
Conclusions:
- Cardiac CT can be judiciously selected to guide further diagnostic pathways.
- Cardiac CT may reduce the need for invasive and expensive coronary angiography.
Abstract:
Cardiac CT has been accepted as a valuable diagnostic tool in today's patient care. However, several other noninvasive, in particular, functional diagnostic tests are available on the menu for the ordering clinician and target more or less the same patient population. These tests come with a cost and financial constraints in the present economic environment will no longer allow its indiscriminate use. The gatekeeper function of a diagnostic testing strategy implies that a test is selected judiciously with the aim of preventing access to invasive yet expensive coronary angiography. On the basis of current knowledge, cardiac CT stands a good chance to claim the position of effective gatekeeper to the cathlab.
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