title: Guidance of percutaneous coronary interventions by multidetector row computed tomography coronary angiography.
abstract: Guidance of percutaneous coronary interventions (PCI) by intravascular ultrasound (IVUS) provides more precise information in terms of quantitative measurement and qualitative assessment of coronary artery disease (CAD) than does conventional angiography. Several studies have tested the efficacy of IVUS to guide stent implantation. However, the conflicting results have left behind a continued debate as to whether IVUS-guided PCI has an impact on clinical outcome and angiographic restenosis. IVUS and computed tomography coronary angiography (CTCA) share the ability to evaluate the lumen along with the vessel wall, enabling characterisation of proximal and distal reference segments. Nevertheless, IVUS imaging is expensive and usually precluded in severe stenoses. In the present article, we discuss the potential application of CTCA for the guidance of PCI, particularly of complex lesions such as chronic total occlusions (CTO) and bifurcations.
authors.affiliation: Department of Cardiovascular Imaging, Otamendi Hospital, Buenos Aires, Argentina. grodriguezgranillo@gmail.com
authors.forename: Gastón A
authors.initials: GA
authors.lastname: Rodríguez-Granillo
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Rosales
authors.forename: Claudio
authors.initials: C
authors.lastname: Llauradó
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Ivanc
authors.forename: Alfredo E
authors.initials: AE
authors.lastname: Rodríguez
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D021621:Imaging, Three-Dimensional; D018579:Patient Selection; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional