CT Determination of Fractional Flow Reserve in Coronary Lesions

Mester, András; Chițu, Monica; Raț, Nóra; Opincariu, Diana; Bordi, Lehel; Stănescu, Anca Daniela; Orzan, Marius; Nyulas, Tiberiu; Benedek, Imre

doi:10.1515/jim-2016-0070

Cited by 3 publications

(2 citation statements)

References 35 publications

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“…This technology has higher specificity and positive predictive value compared to standard CCTA and is being considered a "gatekeeper" strategy to the catheterization laboratory due to the potential rapid evaluation, noninvasive approach, and cost-effectiveness. 8,12,17 As previously described, functionally significant, lesionspecific ischemia is considered at a CT-FFR value ≤0.80. Furthermore, von Knebel Doeberitz et al 12 demonstrated that CT-FFR has higher discriminatory value over CCTA and plaque markers, offering useful information regarding risk stratification.…”

Section: Invasive Identification Methods Of Coronary Plaque Lesionsmentioning

confidence: 99%

Management of Culprit and Non-Culprit Lesions in Acute Coronary Syndrome

Gerculy¹,

Mitra²,

Szabó³

et al. 2021

Journal of Interdisciplinary Medicine

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Multivessel coronary artery disease, defined by the presence of a significant stenosis (≥50% diameter) in two or more epicardial coronary vessels, usually occurs in more than 50% of patients with ST-segment elevation myocardial infarction. The latest guidelines indicate revascularization of the non-culprit artery with a recommendation of class IIB. However, the management of non-culprit lesions in patients with acute coronary syndrome is still a matter of debate. This article presents the most recent concepts related to the management of culprit and non-culprit coronary lesions, based on advanced imaging approaches, in order to identify high-risk patients and prevent further acute coronary syndromes.

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Section: Invasive Identification Methods Of Coronary Plaque Lesionsmentioning

confidence: 99%

Management of Culprit and Non-Culprit Lesions in Acute Coronary Syndrome

Gerculy¹,

Mitra²,

Szabó³

et al. 2021

Journal of Interdisciplinary Medicine

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“…2,3 Obtained either invasively using intracoronary probes or noninvasively using CTderived data and computational fluid dynamics, FFR has a major role in the therapeutic algorithm of patients with complex coronary artery diseases, and the role of modern technologies in obtaining this crucial information is nicely described in the two reviews, proving that FFR has a distinct role in the multimodality imaging approach of the patient with coronary artery disease.…”

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confidence: 99%

Multimodality Cardiac Imaging — a Complex Interdisciplinary Approach Resulting from the CARDIO IMAGE Project

Benedek

2016

Journal of Interdisciplinary Medicine

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Given the multitude of complex and reliable information provided in different clinical settings, cardiac imaging became nowadays an indispensable tool for clinical practitioners and for clinical researchers as well. Invasive and noninvasive technologies have been developed in order to provide the clinicians with the necessary information on cardiovascular structure and function, required for choosing the best therapeutic approach in patients with heart diseases. In line with the modern technological developments, sophisticated imaging methods were implemented in the recent years, able to offer a more complex panel of data regarding heart structures and vascular system, methods which have been validated as cutting-edge technologies and golden-standard techniques, not only for clinical routine, but also for research applications.Invasive cardiac imaging is a tool mainly dedicated to the assessment of coronary vessels during coronary angiography or coronary revascularization procedures. Apart from the classical coronary angiography, such modern invasive imaging tools include optical coherence tomography (OCT), intravascular ultrasound (IVUS) and nearinfrared spectroscopy (NIRS), all of them being frequently used not only for assessment of the severity of a coronary stenosis, but also for estimation of plaque vulnerability, especially in acute settings. However, their role in the evaluation of coronary lesions started to decline in parallel with the rapid development of noninvasive techniques for the visualization of coronary plaques, represented mainly by cardiac computed tomography angiography (CCTA). Being able to provide accurate data regarding stenosis severity and plaque structure and vulnerability, this technique replaced nowadays not only the invasive intracoronary techniques, but also the coronary angiography as a routine method for the visualization of the coronary tree.However, despite being extremely useful for the estimation of the severity of coronary artery diseases on a large scale, none of the above mentioned methods is able to provide a simple information, which is critical for the therapeutic decision, represented by the functional significance of a coronary stenosis. Therefore, new techniques have been developed in order to offer a complex multimodality approach that would be able to answer this question.The functional significance of a coronary stenosis can be assessed nowadays directly or indirectly, using invasive or noninvasive tools. Invasive determination of the fractional flow reserve (FFR) has been validated as a gold-standard technique for the estimation of the functional impact of a coronary stenosis, serving as a useful clinical decision tool. The invasive evaluation of FFR tends to be replaced by noninvasive evaluation using the so-called FFRCT, which implies the determination of the fractional flow reserve remotely, noninvasively, using computational flow dynamics for simulations of the coronary flow. Other imaging-based

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Review. Automatic Segmentation Techniques of the Coronary Artery Using CT Images in Acute Coronary Syndromes

Szilágyi

2017

Journal of Cardiovascular Emergencies

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show that in 2012, 31% of all deaths were caused by cardiovascular disease, from which 7.4 million were due to coronary heart disease. 2 Acute coronary syndromes (ACS)are among the most severe complications of atherosclerosis, and the majority, although not all, take place due to atheromatous plaque rupture and subsequent thrombosis.3 Vulnerable atheromatous plaquesThe genesis of the atheroma is triggered by the appearance of a discontinuity in the endothelial layer, followed by an array of complex mechanical, biochemical, and biological mechanisms that will eventually lead to plaque formation. [4][5][6] The formed atherosclerotic plaque will undergo several pathophysiological changes, including the excessive accumulation of oxidized LDL-cholesterol, enhanced local inflammation, smooth muscle cell proliferation, and extracellular matrix degradation, which will eventually lead to its progression and destabilization. This paper presents the main characteristics of plaque vulnerability, the role of CCTA in the assessment of vulnerable plaques, and automatic segmentation techniques of the coronary artery tree based on CT angiography images. A detailed inventory of existing methods is given, representing the state-of-the-art of computational methods applied in vascular system segmentation, focusing on the current applications in acute coronary syndromes.

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CT Determination of Fractional Flow Reserve in Coronary Lesions

Cited by 3 publications

References 35 publications

Management of Culprit and Non-Culprit Lesions in Acute Coronary Syndrome

Management of Culprit and Non-Culprit Lesions in Acute Coronary Syndrome

Multimodality Cardiac Imaging — a Complex Interdisciplinary Approach Resulting from the CARDIO IMAGE Project

Review. Automatic Segmentation Techniques of the Coronary Artery Using CT Images in Acute Coronary Syndromes

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