RESUMEN
OBJECTIVES: Multislice computed tomography (MSCT) has been currently utilized as a non-invasive diagnostic modality to detect coronary artery disease. We sought to investigate whether preprocedural lesion assessment by MSCT could offer strategic guidance in the setting of elective complex percutaneous coronary intervention (PCI). METHODS AND RESULTS: Twenty-six complex coronary artery lesions in 23 patients were evaluated using 16-row MSCT scanner and an off-line image analysis workstation prior to the PCI. Procedural strategies of PCI were planned based on the morphologic and geometric analysis of the target lesion and vessel. MSCT provided valuable strategic information, which was useful for subsequent PCI procedure. The three-dimensional computed tomography (CT) images allowed us to determine optimal working view angle that best demonstrated the target lesion with least foreshortening. Furthermore, the thin-slab maximum intensity projected CT images of the target lesion served as a preprocedural road map depicting the bends of complex luminal path, vessel geometry and occluded segment of the vessel. As results, procedural success was achieved in all cases with complex lesions including chronic total occlusion. CONCLUSIONS: Our preliminary results showed that preprocedural lesion and vessel assessment by MSCT provided important additive strategic information that led to successful complex PCI procedures.
Asunto(s)
Angioplastia Coronaria con Balón , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/terapia , Tomografía Computarizada por Rayos X/métodos , Anciano , Angiografía Coronaria , Femenino , Fluoroscopía , Humanos , Imagenología Tridimensional , Masculino , Planificación de Atención al Paciente , Interpretación de Imagen Radiográfica Asistida por ComputadorRESUMEN
We present 2 cases of patients with stenotic and occlusive coronary lesions, which were detected by multislice computed tomography (MSCT) coronary angiography and treated with percutaneous coronary intervention (PCI) using CT-oriented optimal fluoroscopic views. Preprocedural MSCT allowed us to select the optimal fluoroscopic angle to visualize the target lesions, which provided least amount of foreshortening and minimal overlap of side branches during the PCI procedures. Given its three-dimensional nature, MSCT provides additional anatomical information in the evaluation of complex coronary lesions prior to PCI.
