Cardiac, CT-Angiography, Diagnostic procedure, Arteriosclerosis
V. Rafailidis, G. Rampidis, K. Kouskouras, A. Davidhi, A. PAPACHRISTODOULOU, G. Giannakoulas, H. Karvounis, P. Prassopoulos
The term “cardiovascular disease” refers to atherosclerosis of coronary and other arterial systems, along with its subsequent effects on the heart. Coronary atherosclerosis is the first cause of mortality in western countries. In Greece, it is estimated that coronary disease entails mortality of 110 deaths per 100.000 people and 16.000 new cases of stable angina annually.
Atherosclerosis predisposing factors would be expected to result in a diffuse and uniform vascular wall thickening, although plaques tend to occur near the origins of arterial branches or in vascular bends, due to flow patterns favoring unusual intimal shear stress. It was found that sudanophilic and fibrous plaques typically affect the outer walls of left coronary bifurcation, while the flow divider and the inner walls downstream were relatively free of disease. Atherosclerosis is common in the medial aspect of curved vessels or lateral walls of bifurcations.[4,5] A brief description of the pathogenesis of atherosclerosis can be found in table 1 (Fig. 1).
Modalities used for imaging coronary disease include interventional angiography and ultrasound, both with a two-dimensional approach to three-dimensional coronary vessels. Modern scanners and technologies rendered coronary computed tomography angiography (CCTA) a superb and widely available modality for the evaluation of coronary anatomy and disease. It can easily assess and quantify coronary arterial geometry and location, extent, and grade of atherosclerosis. Nevertheless, it is still unclear what is the optimal parameter to quantify coronary arteries geometry, its reproducibility, availability and applicability on an everyday clinical setting.