title: Indications for multidetector computed tomographic coronary angiography after catheter-based coronary angiography.
abstract: OBJECTIVE
  This study was designed to evaluate the indications for performing multidetector computed tomographic coronary angiography (MDCTA) after catheter-based coronary angiography.
  
  
  BACKGROUND
  Appropriateness criteria for MDCTA apply exclusively to patient evaluation prior to catheter-based angiography.
  
  
  METHODS
  All MDCTA performed after catheterbased angiography at a tertiary referral center were reviewed.
  
  
  RESULTS
  Fourteen of a total of 2,000 MDCTAs (0.7%) fulfilled the criteria: 14 were performed after catheter-based angiography. The indications were: 1) inability to selectively cannulate a native vessel or graft; 2) severe pressure damping limiting safe angiography; 3) ostial disease; 4) course of anomalous vessels; 5) relationship of bypass grafts to the sternum; 6) graft morphology; 7) chronic total occlusions. In all cases, the MDCTA enabled definitive treatment.
  
  
  CONCLUSIONS
  In a variety of scenarios, MDCT coronary angiography may provide essential information as an adjunctive tool after catheter-based angiography. Indications for MDCTA should be expanded to accommodate these clinical necessities.
authors.affiliation: Lenox Hill Heart and Vascular Institute, 130 E. 77th Street, New York, NY, 10021, USA. hhecht@aol.com
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Hecht
authors.forename: Vladimir
authors.initials: V
authors.lastname: Jelnin
authors.forename: Gary S
authors.initials: GS
authors.lastname: Roubin
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*