Morphological coronary stenosis characteristics by CCTA: comparison with invasive fractional flow reserve

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2016

Poster Number:

B-0381

Type:

Scientific Paper

Keywords:

Abdomen, Absorptiometry / Bone densitometry, Ablation procedures

Authors:

L. Macron, J.-L. Sablayrolles; Saint Denis/FR

DOI:

10.1594/ecr2016/B-0381

DOI-Link:

https://dx.doi.org/10.1594/ecr2016/B-0381

Fig. 1: Purpose is to evaluate clinical severity of moderate coronary artery stenosis...

Fig. 2: 43 arteries (30 patients) with a reference of quantification of stenosis and...

Fig. 4: Coronary CT Angiography one-beat acquisition

Fig. 3: 43 arteries (30 patients) with a reference of quantification of stenosis and...

Fig. 5: No statistically significant difference between groups in demographic...

Fig. 6: Mild coronary artery stenosis (< 50%) evaluated in CCTA are not clinically...

Fig. 7: Conclusion_1

Fig. 8: Conclusion_2

Purpose

To evaluate clinical severity of moderate coronary artery stenosis by using the quantification of stenosis by Coronary CT Angiography (CCTA) one-beat acquisition, Quantitative Coronary Angiography (QCA) and Fractional flow reserve (FFR)

Methods and materials

43 arteries (30 patients) with a reference of quantification of stenosis and FFR assessmentwere retrospectively analyzed by 256-MDCT one-beat acquisition and QCA. The degree of stenosis was evaluated on CCTA and QCA. Stenosis 50-69% were considered as moderate. FFR ≤0,80 was considered as significant

Results

No difference between stenosis degree and length measured by CCTA and QCA (p>0,78 and p>0,71 respectively). Moderate stenosis evaluated in CTA and QCA can predicts FFR≤0,80: with high sensitivity (1,000; 0,697 – 1,000, 95%, Confidential Interval (CI), p< ,05) , moderate specificity (0,656; 0,545 – 0,656, 95% CI, p< ,05), high Negative Predictive Value (NPV) (1,000; 0,856 – 1,000, 95% CI, p< ,05), Positive Predictive Value (PPV) (0,476; 0,322 – 0,322, 95% CI, p< ,05). Moderate stenosis are clinically severe with FFR≤0,8if their length ≥16...

Conclusion

Mild coronary artery stenosis (< 50%) evaluated in CCTA are not clinically severe (FFR≤0,8), thus no indication for revascularization. Moderate stenosis with length ≥16 mm in calcified arteries have to be considered as clinically severe with high proved probability of FFR≤0,80

Personal information

Dr Laurent MACRON, Dr Jean-Louis SABLAYROLLES, Dr Irina TIMOFEEVA, Dr Jacques FEIGNOUX

References

1.Nørgaard BL, Leipsic J, Gaur S, et al. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). J Am Coll Cardiol 2014;63(12):1145–1155. 2. Hausleiter J, Meyer T, Hadamitzky M, et al. Non-invasive coronary computed tomographic angiography for patients with suspected coronary artery disease: the Coronary Angiography by Computed Tomography with the Use of a Submillimeter resolution (CACTUS) trial. Eur Heart J 2007;28(24):3034–3041. 3....