Coronary CTA for Acute Chest Pain in the Emergency Department: Comparison of 64–Detector-Row Single-Source and Third-Generation Dual-Source Scanners

Kim, Ji Hoon; Baek, Seung-Min; Kim, Young Jin; Suh, Young Joo

doi:10.2214/ajr.22.28963

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…Previous studies examined the utility of CT in the evaluation of complications after endovascular procedures, demonstrating a wide range of percentages in terms of acute and chronic complications [17][18][19] and assessing how some of these occurrences may be benign while others are potentially fatal; on the other hand, this is the first report that explores the use of CT in almost all types of endovascular interventions on the heart, including the placement of cardiac pacing devices. This aspect amply justifies the high frequency of complications recorded in a chronic setting.…”

Section: Discussionmentioning

confidence: 99%

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ECG-Gated CCTA in the Assessment of Post-Procedural Complications

Liguori¹,

Lassandro²,

Ferrandino³

et al. 2023

Diagnostics

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Introduction: The aim of our study was to assess the role of ECG-gated coronary CT angiography (CCTA) in the diagnosis, imaging follow-up, and treatment guidance in post-procedural/surgical interventions in the heart and thoracic aorta (PTCA, TAVI, PMK/ICD placement, CABGs). Materials and Methods: We retrospectively evaluated 294 ECG-gated CCTA studies performed in our center from January 2020 to January 2023. CCTA studies were acquired to detect/exclude possible complications related to the endovascular or surgical procedure. Results: There were 27 cases (9.2%) of post-procedural complications. Patients enrolled in the study were 18 males and 9 females (male/female ratio: 2), with age ranging from 47 to 86 years (mean age, 68.3 years). Among percutaneous coronary intervention (PCI) complications, coronary intimal dissection with ascending aorta involvement was found to be the most frequent complication after PTCA (22.2%). Vascular wall pseudoaneurysm formation (11.1%) and coronary stent misalignment or displacement (14.8%) were complications less frequently encountered after PTCA. Right atrial or ventricular perforation with associated hemopericardium were the most common complications (18.5%) after pacemaker implantation. Complications encountered after aortic valve interventions were loosening and dislocation of the prosthesis associated with aortic root pseudoaneurysm (7.4%), para-valvular leak (11.1%), and hemopericardium (7.4%). In one patient who underwent transcatheter repair of patent foramen ovale (3.7%), CTTA detected the dislocation of the Amplatzer septal occluder. Conclusions: ECG-gated CCTA is a fundamental diagnostic tool for the detection of post-procedural endovascular/surgical complications to enable optimal patient management. Radiologists must be familiar with the use of cardiac synchronization in the course of CT and must be aware of all possible complications that can occur in the context of acute settings or routine follow-up studies.

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Section: Discussionmentioning

confidence: 99%

“…The most important aspect in cardiac CT imaging is the cardiac synchronization of the scan, which was adopted in the arterial phase in all our studies. This allows for a precise assessment, especially on cardiac structures and ascending aorta, decreasing nondiagnostic examinations caused by structural movement [2,17].…”

Section: Discussionmentioning

confidence: 99%