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Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

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FFRCT for Complex Coronary Artery Disease Treatment Planning: New Opportunities

Jonathon Leipsic1, Jonathan Weir-McCall1, Philipp Blanke1

  • 1St Paul's Hospital & University of British Columbia, Vancouver, British Columbia Vancouver, Canada.

Interventional Cardiology (London, England)
|November 17, 2018
PubMed

Insights

Coronary computed tomography (CT) angiography combined with fractional flow reserve (FFRCT) now aids complex coronary artery disease management. This review explores FFRCT’s evolving role, opportunities, and remaining questions in guiding revascularization decisions.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Medical Diagnostics

Background:

  • Coronary computed tomography (CT) is established for diagnosing coronary artery disease (CAD) and risk stratification.
  • Coronary CT angiography (CCTA) has had a limited role in managing complex CAD and planning revascularization.
  • Fractional flow reserve (FFR) computed from CT angiography (FFRCT) integrates anatomical and physiological data.

Purpose of the Study:

  • To review the evolving role of FFRCT in managing complex coronary artery disease (CAD).
  • To discuss the opportunities and current data supporting FFRCT in treatment decision-making.
  • To identify unanswered questions regarding FFRCT in complex CAD management.

Main Methods:

  • Review of current literature on FFRCT in complex coronary artery disease.
  • Analysis of studies combining CCTA with FFRCT for lesion-specific pressure loss assessment.
  • Evaluation of FFRCT's impact on revascularization strategies.

Main Results:

  • FFRCT enables simultaneous assessment of coronary anatomy and physiology.
  • It allows for adjudication of lesion-specific pressure loss, improving treatment guidance.
  • The integration of CCTA and FFRCT shows potential in informing complex CAD management.

Conclusions:

  • FFRCT represents a significant advancement in non-invasive assessment of complex coronary artery disease.
  • Combined CCTA and FFRCT offers a powerful tool for guiding revascularization decisions.
  • Further research is needed to address remaining questions and optimize its clinical application.

Keywords:
FFRCT ischaemiacoronary CTAcoronary artery diseaseinvasive coronary angiography (ICA)

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