CT-guided PCI: From diagnosis to treatment planning

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Medical Technology

Background:

• Coronary CT angiography (CCTA) traditionally serves a diagnostic role.
• Percutaneous coronary intervention (PCI) planning can benefit from integrated imaging and physiological data.
• Existing PCI strategies may be enhanced by pre-procedural, detailed lesion characterization.

Purpose of the Study:

• To review the concept, workflow, and clinical applications of CT-guided PCI.
• To highlight the evolution of CCTA from a diagnostic tool to a procedural planning platform.
• To discuss the integration of morphological and physiological data for individualized PCI strategies.

Main Methods:

• Integration of morphological and physiological information from CCTA.
• Utilization of advances in myocardial mass quantification and CT-derived physiology.
• Application of three-dimensional co-registration for enhanced procedural relevance.
• Exploration of emerging technologies like photon-counting CT.

Main Results:

• CCTA provides comprehensive lesion understanding for individualized revascularization.
• CT-guided PCI enhances procedural planning and decision-making.
• Ongoing trials and registries are actively evaluating the clinical utility of CT-guided PCI.

Conclusions:

• CT-guided PCI represents a paradigm shift, leveraging CCTA for precision planning.
• Innovations are transforming CCTA into a central platform for contemporary PCI.
• The transition from diagnosis to comprehensive procedural design is underway, improving PCI strategies.