Incremental value of preprocedural coronary computed tomographic angiography to classical coronary angiography for prediction of PCI complexity in left main stenosis

Benedek, Imre; Chițu, Monica; Kovács, István; Bajka, Balázs; Benedek, Theodora

doi:10.4236/wjcd.2013.39090

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…It has been described that when porous scaffolds are implanted, they are progressively resorbed and substituted by neoformed bone tissue. These process follows a concentric evolution, from the periphery to the center of the implanted material [33][34][35]. The results of this work agree with this process.…”

Section: Discussionsupporting

confidence: 88%

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Intraosteal Behavior of Porous Scaffolds: The mCT Raw-Data Analysis as a Tool for Better Understanding

et al. 2019

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The aim of the study is to determine the existing correlation between high-resolution 3D imaging technique obtained through Micro Computed Tomography (mCT) and histological-histomorphometric images to determine in vivo bone osteogenic behavior of bioceramic scaffolds. A Ca-Si-P scaffold ceramic doped and non-doped (control) with a natural demineralized bone matrix (DBM) were implanted in rabbit tibias for 1, 3, and 5 months. A progressive disorganization and disintegration of scaffolds and bone neoformation occurs, from the periphery to the center of the implants, without any differences between histomorphometric and radiological analysis. However, significant differences (p < 0.05) between DMB-doped and non-doped materials where only detected through mathematical analysis of mCT. In this way, average attenuation coefficient for DMB-doped decreased from 0.99 ± 0.23 Hounsfield Unit (HU) (3 months) to 0.86 ± 0.32 HU (5 months). Average values for non-doped decreased from 0.86 ± 0.25 HU (3 months) to 0.66 ± 0.33 HU. Combination of radiological analysis and mathematical mCT seems to provide an adequate in vivo analysis of bone-implanted biomaterials after surgery, obtaining similar results to the one provided by histomorphometric analysis. Mathematical analysis of Computed Tomography (CT) would allow the conducting of long-term duration in vivo studies, without the need for animal sacrifice, and the subsequent reduction in variability.

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Section: Discussionsupporting

confidence: 88%

“…Recent advances in CT technology are contributing to this purpose. Clear examples can be found in CT angiography, which is a non-invasive alternative to classical coronary angiography [35,36]. Applied to biomedical experimentation on animal models, improvement of imaging analysis techniques can replace invasive histological studies.…”

Section: Discussionmentioning

confidence: 99%

Intraosteal Behavior of Porous Scaffolds: The mCT Raw-Data Analysis as a Tool for Better Understanding

et al. 2019

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“…19 Lesion complexity (including location, vessel tortuosity and major calcifications) was indicated to influence not only interventional treatment procedure complexity, but also short-and long-term outcomes, and preprocedural CCTA patient evaluation and lesion characterization became an important step in PCI planning. 20,21 With improved spatial and temporal resolution, CCTA offers three-dimensional images of the coronary arteries and may characterize stenotic lesions. CCTA provides a detailed anatomic evaluation of coronary artery lesions, identifying the extent of the stenosis and its severity.…”

Section: Noninvasive Ccta Evaluation Of Cadmentioning

confidence: 99%

Noninvasive Assessment of Coronary Artery Disease: Fractional Flow Reserved Derived from Coronary Computed Tomography Angiography (FFRCT)

Raţiu¹,

Raț

Condrea³

et al. 2016

Journal of Interdisciplinary Medicine

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Invasive coronary angiography (ICA) completed by fractional flow reserve (FFR) assessment represents the main procedure that is performed in the decision process for coronary revascularization. Coronary Computed Tomography Angiography (CCTA) is an effective method used in the noninvasive anatomic assessment of coronary artery disease (CAD). However, CCTA tends to overestimate and does not offer hemodynamic data about the coronary lesions. Recent progresses made in the research involving computational fluid dynamics and image modeling permit the evaluation of FFRCT noninvasively, using data obtained in a standard CCTA. Studies have shown an improved precision and discrimination of FFRCT compared to CCTA for the diagnosis of significant coronary artery stenosis. In this review, we aimed to summarize the role of CCTA in CAD evaluation, the impact of FFRCT, the scientific basis of this novel method and its potential clinical applications.

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“…8,9 CTA evaluation has become one of the most popular imaging techniques in cardiology, its relevance in vulnerable coronary plaque evaluation being widely accepted. [10][11][12][13][14] In a recent study, conducted on 238 patients enrolled in the ABSORB II trial with 258 coronary ath-erosclerotic lesions treated with bioresorbable scaffolds, subjects were evaluated via invasive angiography, intravascular ultrasound (IVUS), and CTA at the 3-year follow-up after PCI. After analyzing the results, CTA proved to have a similar diagnostic precision to conventional angiography in terms of identifying and quantifying the severity of ISR.…”

Section: Introductionmentioning

confidence: 99%

CTA Evaluation of Bioresorbable Scaffolds versus Metallic Coronary Stents – a Feasibility Study

Ferenţ

Mester

Chițu

et al. 2018

Journal of Interdisciplinary Medicine

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Background: Computed tomography angiography (CTA) presents important limits in in-stent restenosis (ISR) evaluation in case of metallic coronary stents, due to the artifacts determined by stent struts, which alter in-stent plaque analysis. In case of bioresorbable scaffolds, stent strut resorption allows accurate evaluation of the vessel wall. Aim of the study: This study aims to compare the feasibility of CTA as a follow-up imaging method for ISR diagnosis following elective PTCA procedures, between bioresorbable scaffolds and metallic coronary stents. Material and methods: We conducted a prospective, observational study on 73 patients with elective PTCA procedures in their medical history, in whom 113 stents were assessed via CTA in order to diagnose ISR. Based on stent type, the patients were divided into two groups: Group 1 -patients with bioresorbable vascular scaffolds (BVS) (n = 30); and Group 2 -patients with bare metal stents (BMS) (n = 43). Plaque analysis was possible only in the BVS group with a post-processing research-dedicated software, Syngo.via Frontier, which identified plaque morphology and virtual histology composition. Results: After CTA evaluation, the BVS group presented a significantly higher incidence of severe coronary artery disease (CAD) (Group 1 -73% vs. Group 2 -30%, p <0.0001). The proximal part of the right coronary artery (RCA) presented a significantly higher percentage of metallic stents (14% BMS vs. 2% BVS, p = 0.0029). The comparative analysis of CTA sensibility for the visual evaluation of ISR identified a significantly higher percentage of diagnostic CT evaluations in the BVS group (Group 1 -94% vs. Group 2 -76.19%, p = 0.0006). CTA evaluation provided the most accurate results for the 3.0 and 3.5 mm devices. Regarding CTA sensibility for ISR diagnosis, the BVS group presented the smallest incidence of non-diagnostic CT evaluations. Conclusions: CTA evaluation of bioresorbable scaffolds is superior to metallic stent assessment, the latter being influenced by numerous sources of error dependent mainly on the presence of the metal structure.

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Incremental value of preprocedural coronary computed tomographic angiography to classical coronary angiography for prediction of PCI complexity in left main stenosis

Cited by 4 publications

References 12 publications

Intraosteal Behavior of Porous Scaffolds: The mCT Raw-Data Analysis as a Tool for Better Understanding

Intraosteal Behavior of Porous Scaffolds: The mCT Raw-Data Analysis as a Tool for Better Understanding

Noninvasive Assessment of Coronary Artery Disease: Fractional Flow Reserved Derived from Coronary Computed Tomography Angiography (FFRCT)

CTA Evaluation of Bioresorbable Scaffolds versus Metallic Coronary Stents – a Feasibility Study

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