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Cardiac Computed Tomography in Monitoring Revascularization

The use of coronary computed tomography angiography (CCTA) in the setting of stable coronary artery disease is highly recommended for low-risk patients. High-risk patients, such as symptomatic subjects with prior revascularization, are suggested to be investigated with noninvasive functional tests o...

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Autores principales: Tonet, Elisabetta, Amantea, Veronica, Lapolla, Davide, Assabbi, Paolo, Boccadoro, Alberto, Berloni, Maria Letizia, Micillo, Marco, Marchini, Federico, Chiarello, Serena, Cossu, Alberto, Campo, Gianluca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10672590/
https://www.ncbi.nlm.nih.gov/pubmed/38002715
http://dx.doi.org/10.3390/jcm12227104
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author Tonet, Elisabetta
Amantea, Veronica
Lapolla, Davide
Assabbi, Paolo
Boccadoro, Alberto
Berloni, Maria Letizia
Micillo, Marco
Marchini, Federico
Chiarello, Serena
Cossu, Alberto
Campo, Gianluca
author_facet Tonet, Elisabetta
Amantea, Veronica
Lapolla, Davide
Assabbi, Paolo
Boccadoro, Alberto
Berloni, Maria Letizia
Micillo, Marco
Marchini, Federico
Chiarello, Serena
Cossu, Alberto
Campo, Gianluca
author_sort Tonet, Elisabetta
collection PubMed
description The use of coronary computed tomography angiography (CCTA) in the setting of stable coronary artery disease is highly recommended for low-risk patients. High-risk patients, such as symptomatic subjects with prior revascularization, are suggested to be investigated with noninvasive functional tests or invasive coronary angiography. CCTA is not considered for these patients because of some well-known CCTA artifacts, such as blooming and motion artifacts. However, new technology has allowed us to obtain images with high spatial resolution, overcoming these well-known limitations of CCTA. Furthermore, the introduction of CT-derived fractional flow reserve and stress CT perfusion has made CCTA a comprehensive examination, including anatomical and functional assessments of coronary plaques. Additionally, CCTA allows for plaque characterization, which has become a cornerstone for the optimization of medical therapy, which is not possible with functional tests. Recent evidence has suggested that CCTA could be used with the aim of monitoring revascularization, both after coronary bypass grafts and percutaneous coronary intervention. With this background information, CCTA can also be considered the exam of choice in subjects with a history of revascularization. The availability of a noninvasive anatomic test for patients with previous coronary revascularization and its possible association with functional assessments in a single exam could play a key role in the follow-up management of these subjects, especially considering the rate of false-positive and negative results of noninvasive functional tests. The present review summarizes the main evidence about CCTA and coronary artery bypass grafts, complex percutaneous coronary intervention, and bioresorbable stent implantation.
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spelling pubmed-106725902023-11-15 Cardiac Computed Tomography in Monitoring Revascularization Tonet, Elisabetta Amantea, Veronica Lapolla, Davide Assabbi, Paolo Boccadoro, Alberto Berloni, Maria Letizia Micillo, Marco Marchini, Federico Chiarello, Serena Cossu, Alberto Campo, Gianluca J Clin Med Review The use of coronary computed tomography angiography (CCTA) in the setting of stable coronary artery disease is highly recommended for low-risk patients. High-risk patients, such as symptomatic subjects with prior revascularization, are suggested to be investigated with noninvasive functional tests or invasive coronary angiography. CCTA is not considered for these patients because of some well-known CCTA artifacts, such as blooming and motion artifacts. However, new technology has allowed us to obtain images with high spatial resolution, overcoming these well-known limitations of CCTA. Furthermore, the introduction of CT-derived fractional flow reserve and stress CT perfusion has made CCTA a comprehensive examination, including anatomical and functional assessments of coronary plaques. Additionally, CCTA allows for plaque characterization, which has become a cornerstone for the optimization of medical therapy, which is not possible with functional tests. Recent evidence has suggested that CCTA could be used with the aim of monitoring revascularization, both after coronary bypass grafts and percutaneous coronary intervention. With this background information, CCTA can also be considered the exam of choice in subjects with a history of revascularization. The availability of a noninvasive anatomic test for patients with previous coronary revascularization and its possible association with functional assessments in a single exam could play a key role in the follow-up management of these subjects, especially considering the rate of false-positive and negative results of noninvasive functional tests. The present review summarizes the main evidence about CCTA and coronary artery bypass grafts, complex percutaneous coronary intervention, and bioresorbable stent implantation. MDPI 2023-11-15 /pmc/articles/PMC10672590/ /pubmed/38002715 http://dx.doi.org/10.3390/jcm12227104 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Tonet, Elisabetta
Amantea, Veronica
Lapolla, Davide
Assabbi, Paolo
Boccadoro, Alberto
Berloni, Maria Letizia
Micillo, Marco
Marchini, Federico
Chiarello, Serena
Cossu, Alberto
Campo, Gianluca
Cardiac Computed Tomography in Monitoring Revascularization
title Cardiac Computed Tomography in Monitoring Revascularization
title_full Cardiac Computed Tomography in Monitoring Revascularization
title_fullStr Cardiac Computed Tomography in Monitoring Revascularization
title_full_unstemmed Cardiac Computed Tomography in Monitoring Revascularization
title_short Cardiac Computed Tomography in Monitoring Revascularization
title_sort cardiac computed tomography in monitoring revascularization
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10672590/
https://www.ncbi.nlm.nih.gov/pubmed/38002715
http://dx.doi.org/10.3390/jcm12227104
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