Coronary CT in Patients with a History of PCI or CABG: Helpful or Harmful?
Ayman Jubran, Martin J. Willemink, Koen Nieman
Purpose of Review The purpose of this review is to evaluate the role of coronary computed tomography angiography (CCTA) in the assessment of patients after coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI).
Recent Findings Advances in CT technology have resulted in tremendous improvements in diagnostic performance, safety, and ease of performance. CCTA accurately detects graft stenosis or occlusion. However, assessment of native coronary arteries in patients after CABG is challenging due to commonly present severe coronary calcifications. CCTA evaluation of coronary stents using contemporary technology allows for exclusion of in-stent restenosis in suitable patients with larger stents (diameter ≥ 3 mm). Recent studies show promising results for assessment of smaller stents (diameter < 3 mm).
Summary CCTA is a non-invasive, low-risk, and lower-cost alternative to invasive coronary angiography (ICA) for evaluation of patients after CABG or stents. Combining CCTA with myocardial CT perfusion or CT-based fractional flow reserve as well as photon-counting CT may expand its role for assessment of these patients.
Read Full Article Here: https://doi.org/10.1007/s12410-019-9496-2