Controversies in the Use of Fractional Flow Reserve Form Computed Tomography (FFRCT) vs. Coronary Angiography

被引：6

作者：

Al-Mallah M.H. ^{[1
]}

Ahmed A.M. ^{[1
]}

机构：

[1] King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Cardiac Center, Ministry of National Guard, Health Affairs, 1413, P.O. Box 22490, Riyadh

来源：

Current Cardiovascular Imaging Reports | 2016年 / 9卷 / 12期

关键词：

Coronary computed tomography angiography; Fractional flow reserve (FFR); Invasive coronary angiography;

D O I：

10.1007/s12410-016-9396-7

中图分类号：

学科分类号：

摘要：

Purpose of Review: Invasive coronary angiography (ICA) is the gold standard for the anatomical assessment of coronary artery disease. In addition, it provides assessment to coronary physiology and myocardial blood flow through fractional flow reserve (FFR). Furthermore, invasive FFR provides a clear road map that helps in the management of suspected coronary artery disease patients especially if an intermediate coronary lesion is considered. Despite all these developments, this invasive technique carries its own risk. Non-invasive coronary assessment using coronary computed tomography angiography (CCTA) is now an established tool for the evaluation of coronary artery disease. Recent Findings: Recent technology allows the measurement of FFR using CCTA imaging. This technique was studied in a number of papers that confirmed its validity, accuracy, clinical utility and cost-effectiveness. However, this technique continues to have some challenges. In this paper, we will review the data related to this new promising technique as well as its clinical implications, limitations and challenges. Summary: FFRCT is a promising tool that will provide valuable clinical information needed in the management of multiple clinical scenarios. It is expected to grow further in the near future and have significant clinical impact once its clinical role is further defined and workflow is simplified. © 2016, Springer Science+Business Media New York.

引用

共 55 条

[1]

Al-Mallah M.H., Aljizeeri A., Villines T.C., Srichai M.B., Alsaileek A., Cardiac computed tomography in current cardiology guidelines, J Cardiovasc Comput Tomogr, 9, pp. 514-523, (2015)

[2]

Raff G.L., Gallagher M.J., O'Neill W.W., Goldstein J.A., Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography, J Am Coll Cardiol, 46, pp. 552-557, (2005)

[3]

Douglas P.S., Hoffmann U., Anatomical versus functional testing for coronary artery disease, N Engl J Med, 373, (2015)

[4]

Chinnaiyan K.M., Peyser P., Goraya T., Ananthasubramaniam K., Gallagher M., Depetris A., Et al., Impact of a continuous quality improvement initiative on appropriate use of coronary computed tomography angiography. Results from a multicenter, statewide registry, the Advanced Cardiovascular Imaging Consortium, J Am Coll Cardiol, 60, pp. 1185-1191, (2012)

[5]

Min J.K., Hachamovitch R., Rozanski A., Shaw L.J., Berman D.S., Gibbons R., Clinical benefits of noninvasive testing: coronary computed tomography angiography as a test case, JACC Cardiovasc Imaging, 3, pp. 305-315, (2010)

[6]

Shaw L.J., Hausleiter J., Achenbach S., Al-Mallah M., Berman D.S., Budoff M.J., Et al., Coronary computed tomographic angiography as a gatekeeper to invasive diagnostic and surgical procedures: results from the multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: an International Multicenter) registry, J Am Coll Cardiol, 60, pp. 2103-2114, (2012)

[7]

Marwick T.H., Cho I., O Hartaigh B., Min J.K., Finding the gatekeeper to the cardiac catheterization laboratory: coronary CT angiography or stress testing?, J Am Coll Cardiol, 65, pp. 2747-2756, (2015)

[8]

Investigators T., Trial of invasive versus medical therapy in elderly patients with chronic symptomatic coronary-artery disease (TIME): a randomised trial, Lancet, 358, pp. 951-957, (2001)

[9]

Montalescot G., Sechtem U., Achenbach S., Andreotti F., Arden C., Budaj A., Et al., 2013 ESC guidelines on the management of stable coronary artery disease, Eur Heart J, 34, pp. 2949-3003, (2013)

[10]

De Bruyne B., Baudhuin T., Melin J.A., Pijls N.H., Sys S.U., Bol A., Et al., Coronary flow reserve calculated from pressure measurements in humans. Validation with positron emission tomography, Circulation, 89, pp. 1013-1022, (1994)

← 1 2 3 4 5 6 →