Conclusion
Physicians should embrace non-invasive coronary angiography as a helpful addition to the armamentarium with which to diagnose and help combat cardiovascular disease. In selected patients, coronary CTA can be useful to rule out significant coronary artery or bypass graft stenoses and this helps avoid unnecessary invasive coronary angiograms. In the future, an important application may be in the anatomic definition of plaque burden and composition. Technical improvements will continue to broaden the spectrum of patients who may profit from computed tomographic imaging of the coronary arteries.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Weidner W, MacAlpin R, Hanafee W, Kattus A. Percutaneous transaxillary selective coronary angiography. Radiology 1965;85(4):652–657.
Selinger H. Selective coronary cine-angiography. W V Med J 1966; 62(10):336–337.
Benchimol A, Tippit HC, Maia IG. The clinical value of selective coronary angiography. Ariz Med 1967;24(11):1067–1072.
Sketch MH. Selective cine coronary angiography in the diagnosis of ischemic heart disease. Chronicle 1967;30(5):151.
Spellberg RD, Unger I. The percutaneous femoral artery approach to selective coronary arteriography. Circulation 1967;36(5):730–733.
Bourassa MG, Lesperance J, Campeau L. Selective coronary arteriography by the percutaneous femoral artery approach. Am J Roentgenol Radium Ther Nucl Med 1969;107(2):377–383.
Banerjee S, Crook AM, Dawson JR, Timmis AD, Hemingway H. Magnitude and consequences of error in coronary angiography interpretation (the ACRE study). Am J Cardiol 2000;85(3):309–314.
Goldberg RK, Kleiman NS, Minor ST, Abukhalil J, Raizner AE. Comparison of quantitative coronary angiography to visual estimates of lesion severity pre and post PTCA. Am Heart J 1990;119(1):178–184.
Herrington DM, Siebes M, Walford GD. Sources of error in quantitative coronary angiography. Cathet Cardiovasc Diagn 1993;29(4): 314–321.
Macieira-Coelho E, Cantinho G, da Costa BB, et al. Minimal residual coronary obstructions in patients who suffered a first myocardial infarction. A prospective study comparing coronary angiography and exercise thallium scintigraphy. Clin Cardiol 1993;16(12):879–882.
Nissen SE, Gurley JC. Application of intravascular ultrasound for detection and quantitation of coronary atherosclerosis. Int J Card Imaging 1991;6(3–4):165–177.
Topol EJ, Nissen SE. Our preoccupation with coronary luminology. The dissociation between clinical and angiographic findings in ischemic heart disease. Circulation 1995;92(8):2333–2342.
Arnett EN, Isner JM, Redwood DR, et al. Coronary artery narrowing in coronary heart disease: comparison of cineangiographic and necropsy findings. Ann Intern Med1979;91(3):350–356.
Yamashita T, Colombo A, Tobis JM. Limitations of coronary angiography compared with intravascular ultrasound: implications for coronary interventions. Prog Cardiovasc Dis 1999;42(2):91–138.
Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med1987;316(22):1371–1375.
Stiel GM, Stiel LS, Schofer J, Donath K, Mathey DG. Impact of compensatory enlargement of atherosclerotic coronary arteries on angiographic assessment of coronary artery disease. Circulation 1989;80(6):1603–1609.
Kennedy JW, Baxley WA, Bunnel IL, et al. Mortality related to cardiac catheterization and angiography. Cathet Cardiovasc Diagn 1982; 8(4):323–340.
Noto TJ Jr, Johnson LW, Krone R, et al. Cardiac catheterization 1990: a report of the Registry of the Society for Cardiac Angiography and Interventions (SCA&I). Cathet Cardiovasc Diagn 1991;24(2):75–83.
Scanlon PJ, Faxon DP, Audet AM, et al. ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol 1999;33(6):1756–1824.
Heuser RR. Outpatient coronary angiography: indications, safety, and complication rates. Herz 1998;23(1):21–26.
Ammann P, Brunner-La Rocca HP, Angehrn W, Roelli H, Sagmeister M, Rickli H. Procedural complications following diagnostic coronary angiography are related to the operator’s experience and the catheter size. Catheter Cardiovasc Interv 2003;59(1):13–18.
Abu-Ful A, Benharroch D, Henkin Y. Extraction of the radial artery during transradial coronary angiography: an unusual complication. J Invasive Cardiol 2003;15(6):351–352.
Fagih B, Beaudry Y. Pseudoaneurysm: a late complication of the transradial approach after coronary angiography. J Invasive Cardiol 2000;12(4):216–217.
Gellen B, Remp T, Mayer T, Milz P, Franz WM. Cortical blindness: a rare but dramatic complication following coronary angiography. Cardiology 2003;99(1):57–59.
Jain D, Kurz T, Katus HA, Richardt G. A unique complication during coronary angiography: peripheral embolism by selective right coronary engagement — a case report. Angiology 2001;52(7):493–499.
Liu JC, Cziperle DJ, Kleinman B, Loeb H. Coronary abscess: a complication of stenting. Catheter Cardiovasc Interv 2003;58(1):69–71.
Lubavin BV. Retroperitoneal hematoma as a complication of coronary angiography and stenting. Am J Emerg Med2004;22(3):236–238.
Timurkaynak T, Ciftci H, Cemri M. Coronary artery perforation: a rare complication of coronary angiography. Acta Cardiol 2001;56(5): 323–325.
deFilippi CR, Rosanio S, Tocchi M, et al. Randomized comparison of a strategy of predischarge coronary angiography versus exercise testing in low-risk patients in a chest pain unit: in-hospital and long-term outcomes. J Am Coll Cardiol 2001;37(8):2042–2049.
Wyer PC. Predischarge coronary angiography was better than exercise testing for reducing hospital use after low-risk chest pain. ACP J Club 2002;136(1):8.
Gandelman G, Bodenheimer MM. Screening coronary arteriography in the primary prevention of coronary artery disease. Heart Dis 2003;5(5):335–344.
Mollet NR, Cademartiri F, Krestin GP, et al. Improved diagnostic accuracy with 16-row multi-slice computed tomography coronary angiography. J Am Coll Cardiol 2005;45:128–132.
Kuettner A, Beck T, Drosch T, et al. Diagnostic accuracy of noninvasive coronary imaging using 16-detector slice spiral computed tomography with 188ms temporal resolution. J Am Coll Cardiol 2005;45:123–127.
Schuijf JD, Bax JJ, Salm LP, et al. Noninvasive coronary imaging and assessment of left ventricular function using 16-slice computed tomography. Am J Cardiol 2005;95:571–574.
Martuscelli E, Romagnoli A, D’Eliseo A, et al. Accuracy of thin-slice computed tomography in the detection of coronary stenoses. Eur Heart J 2004;25:1043–1048.
Hoffmann U, Moselewski F, Cury RC, et al. Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease: patient-versus segment-based analysis. Circulation 2004;110(17):2638–2643.
Kuettner A, Trabold T, Schroeder S, et al. Noninvasive detection of coronary lesions using 16-detector multislice spiral computed tomography technology: initial clinical results. J Am Coll Cardiol 2004;44(6):1230–1237.
Martuscelli E, Romagnoli A, D’Eliseo A, et al. Evaluation of venous and arterial conduit patency by 16-slice spiral computed tomography. Circulation 2004;110(20):3234–3238.
Mollet NR, Cademartiri F, Nieman K, et al. Multislice spiral computed tomography coronary angiography in patients with stable angina pectoris. J Am Coll Cardiol2004;43(12):2265–2270.
Schlosser T, Konorza T, Hunold P, Kuhl H, Schmermund A, Barkhausen J. Noninvasive visualization of coronary artery bypass grafts using 16-detector row computed tomography. J Am Coll Cardiol 2004;44(6):1224–1229.
Schuijf JD, Bax JJ, Jukema JW, et al. Noninvasive evaluation of the coronary arteries with multislice computed tomography in hypertensive patients. Hypertension 2004;45(2):227–232.
Schuijf JD, Bax JJ, Jukema JW, et al. Noninvasive angiography and assessment of left ventricular function using multislice computed tomography in patients with type 2 diabetes. Diabetes Care 2004; 27(12):2905–2910.
Burgstahler C, Kuettner A, Kopp AF, et al. Non-invasive evaluation of coronary artery bypass grafts using multi-slice computed tomography: initial clinical experience. Int J Cardiol2003;90(2–3):275–280.
Ropers D, Baum U, Pohle K, et al. Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. Circulation 2003;107(5):664–666.
Kopp AF, Schroeder S, Kuettner A, et al. Non-invasive coronary angiography with high resolution multidetector-row computed tomography. Results in 102 patients. Eur Heart J 2002;23(21):1714–1725.
Nieman K, Rensing BJ, van Geuns RJ, et al. Usefulness of multislice computed tomography for detecting obstructive coronary artery disease. Am J Cardiol 2002;89(8):913–918.
Achenbach S, Moselewski F, Ropers D, et al. Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: a segment-based comparison with intravascular ultrasound. Circulation 2004;109(1):14–17.
Leber AW, Knez A, Becker A, et al. Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: a comparative study with intracoronary ultrasound. J Am Coll Cardiol 2004;43(7): 1241–1247.
Schroeder S, Kuettner A, Leitritz M, et al. Reliability of differentiating human coronary plaque morphology using contrast-enhanced multislice spiral computed tomography: a comparison with histology. J Comput Assist Tomogr 2004;28(4):449–454.
Caussin C, Ohanessian A, Lancelin B, et al. Coronary plaque burden detected by multislice computed tomography after acute myocardial infarction with near-normal coronary arteries by angiography. Am J Cardiol 2003;92(7):849–852.
Inoue F, Sato Y, Matsumoto N, Tani S, Uchiyama T. Evaluation of plaque texture by means of multislice computed tomography in patients with acute coronary syndrome and stable angina. Circ J 2004;68(9):840–844.
Leber AW, Knez A, White CW, et al. Composition of coronary atherosclerotic plaques in patients with acute myocardial infarction and stable angina pectoris determined by contrast-enhanced multislice computed tomography. Am J Cardiol 2003;91(6):714–718.
Yuichi S, Takako I, Fumio I, et al. Detection of atherosclerotic coronary artery plaques by multislice spiral computed tomography in patients with acute coronary syndrome: report of 2 cases. Circ J 2004;68(3):263–266.
Arampatzis CA, Ligthart JM, Schaar JA, Nieman K, Serruys PW, de Feyter PJ. Images in cardiovascular medicine. Detection of a vulnerable coronary plaque: a treatment dilemma. Circulation 2003;108(5):e34–35.
Gyongyosi M, Yang P, Hassan A, et al. Intravascular ultrasound predictors of major adverse cardiac events in patients with unstable angina. Clin Cardiol 2000;23(7):507–515.
Rasheed Q, Nair RN, Sheehan HM, Hodgson JM. Coronary artery plaque morphology in stable angina and subsets of unstable angina: an in vivo intracoronary ultrasound study. Int J Card Imaging 1995;11(2):89–95.
Achenbach S, Ropers D, Hoffmann U, et al. Assessment of coronary remodeling in stenotic and nonstenotic coronary atherosclerotic lesions by multidetector spiral computed tomography. J Am Coll Cardiol 2004;43(5):842–847.
Imazeki T, Sato Y, Inoue F, et al. Evaluation of coronary artery remodeling in patients with acute coronary syndrome and stable angina by multislice computed tomography. Circ J 2004;68(11):1045–1050.
Schoenhagen P, Tuzcu EM, Stillman AE, et al. Non-invasive assessment of plaque morphology and remodeling in mildly stenotic coronary segments: comparison of 16-slice computed tomography and intravascular ultrasound. Coronary Artery Dis 2003;14: 459–462.
Achenbach S, Moshage W, Ropers D, Bachmann K. Comparison of vessel diameters in electron beam tomography and quantitative coronary angiography. Int J Card Imaging 1998;14(1):1–7; discussion 9.
Curtis MJ, Traboulsi M, Knudtson ML, Lester WM. Left main coronary artery dissection during cardiac catheterization. Can J Cardiol 1992;8(7):725–728.
Devlin G, Lazzam L, Schwartz L. Mortality related to diagnostic cardiac catheterization. The importance of left main coronary disease and catheter induced trauma. Int J Card Imaging1997; 13(5):379–384; discussion 385–386.
Koos R, Mahnken AH, Sinha AM, Wildberger JE, Hoffmann R. ECG-gated multislice spiral computed tomography to clarify lesion severity in a case of left main stenosis. Multislice spiral computed tomography to clarify lesion severity. Int J Cardiovasc Imaging 2003;19(4):349–353.
Schuijf JD, Bax JJ, Jukema JW, et al. Feasibility of assessment of coronary stent patency using 16-slice computed tomography. Am J Cardiol 2004;94(4):427–430.
Gilard M, Cornily JC, Rioufol G, et al. Noninvasive assessment of left main coronary stent patency with 16-slice computed tomography. Am J Cardiol. 2005;95:110–112.
Mollet NR, Cademartiri F. Images in cardiovascular medicine. Instent neointimal hyperplasia with 16-row multislice computed tomography coronary angiography. Circulation2004;110(21):e514.
Rossi R, Chiurlia E, Ratti C, Ligabue G, Romagnoli R, Modena MG. Noninvasive assessment of coronary artery bypass graft patency by multislice computed tomography. Ital Heart J 2004;5(1):36–41.
Ropers D, Ulzheimer S, Wenkel E, et al. Investigation of aortocoronary artery bypass grafts by multislice spiral computed tomography with electrocardiographic-gated image reconstruction. Am J Cardiol 2001;88(7):792–795.
Schussler JM, Hamman BL. Multislice cardiac computed tomography of symmetry bypass connector. Heart 2004;90(12):1480.
Johannesson M. At what coronary risk level is it c ost-effective to initiate cholesterol lowering drug treatment in primary prevention? Eur Heart J 2001;22(11):919–925.
Brandle M, Davidson MB, Schriger DL, Lorber B, Herman WH. Cost effectiveness of statin therapy for the primary prevention of major coronary events in individuals with type 2 diabetes. Diabetes Care 2003;26(6):1796–1801.
Hay JW, Yu WM, Ashraf T. Pharmacoeconomics of lipid-lowering agents for primary and secondary prevention of coronary artery disease. Pharmacoeconomics 1999;15(1):47–74.
Blake GJ, Ridker PM, Kuntz KM. Potential cost-effectiveness of C-reactive protein screening followed by targeted statin therapy for the primary prevention of cardiovascular disease among patients without overt hyperlipidemia. Am J Med 2003;114(6):485–494.
De S, Searles G, Haddad H. The prevalence of cardiac risk factors in women 45 years of age or younger undergoing angiography for evaluation of undiagnosed chest pain. Can J Cardiol 2002;18(9):945–948.
Ethevenot G, Westphal JC, Massin N, et al. [Normal coronary angiography. Have the indications changed during the 1980s?]. Arch Mal Coeur Vaiss 1997;90(7):905–910.
Christiaens L, Allal J, Martin Landragin I, et al. [Normal coronary angiography. Survival and functional status at 6 years]. Arch Mal Coeur Vaiss 2000;93(12):1515–1519.
Papanicolaou MN, Califf RM, Hlatky MA, et al. Prognostic implications of angiographically normal and insignificantly narrowed coronary arteries. Am J Cardiol 1986;58(13):1181–1187.
Mukerji V, Alpert MA, Hewett JE, Parker BM. Can patients with chest pain and normal coronary arteries be discriminated from those with coronary artery disease prior to coronary angiography? Angiology 1989;40(4 Pt 1):276–282.
Dolan MS, Riad K, El-Shafei A, et al. Effect of intravenous contrast for left ventricular opacification and border definition on sensitivity and specificity of dobutamine stress echocardiography compared with coronary angiography in technically difficult patients. Am Heart J 2001;142(5):908–915.
Afridi I, Quinones MA, Zoghbi WA, Cheirif J. Dobutamine stress echocardiography: sensitivity, specificity, and predictive value for future cardiac events. Am Heart J 1994;127(6):1510–1515.
Schwartz JG, Johnson RB, Aepfelbacher FC, et al. Sensitivity, specificity and accuracy of stress SPECT myocardial perfusion imaging for detection of coronary artery disease in the distribution of first-order branch vessels, using an anatomical matching of angiographic and perfusion data. Nucl Med Commun 2003;24(5):543–549.
Fava S, Azzopardi J, Agius-Muscat H. Outcome of unstable angina in patients with diabetes mellitus. Diabet Med 1997;14(3):209–213.
Hayashino Y, Nagata-Kobayashi S, Morimoto T, Maeda K, Shimbo T, Fukui T. Cost-effectiveness of screening for coronary artery disease in asymptomatic patients with type 2 diabetes and additional atherogenic risk factors. J Gen Intern Med 2004;19(12):1181–1191.
Lee DP, Fearon WF, Froelicher VF. Clinical utility of the exercise ECG in patients with diabetes and chest pain. Chest 2001;119(5):1576–1581.
Schussler JM, Dockery WD, Johnson KB, Rosenthal RL, Schumacher JR, Stoler RC. Images in cardiovascular medicine. Superiority of computed tomography coronary angiography over calcium scoring to accurately evaluate atherosclerotic disease in a 35-year-old man. Circulation 2004;109(23):e318–e319.
Pasowicz M, Klimeczek P, Wicher-Muniak E, et al. The use of coronary artery multislice spiral computed tomography (MSCT) to identify patients for surgical revascularisation. Acta Cardiol 2004;59(2): 221–222.
Meier B, Ramamurthy S. Plaque sealing by coronary angioplasty. Cathet Cardiovasc Diagn 1995;36(4):295–297.
Meier B. Plaque sealing or plumbing for coronary artery stenoses? Circulation1997;96(6):2094–2095.
Mercado N, Maier W, Boersma E, et al. Clinical and angiographic outcome of patients with mild coronary lesions treated with balloon angioplasty or coronary stenting. Implications for mechanical plaque sealing. Eur Heart J 2003;24(6):541–551.
Meier B. Plaque sealing by coronary angioplasty. Heart 2004;90(12): 1395–1398.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2006 Springer-Verlag London Limited
About this chapter
Cite this chapter
Schussler, J.M. (2006). An Interventionalist’s Perspective: Diagnosis of Cardiovascular Disease by CT Imaging. In: Budoff, M.J., Shinbane, J.S., Achenbach, S., Raggi, P., Rumberger, J.A. (eds) Cardiac CT Imaging. Springer, London . https://doi.org/10.1007/1-84628-146-6_11
Download citation
DOI: https://doi.org/10.1007/1-84628-146-6_11
Publisher Name: Springer, London
Print ISBN: 978-1-84628-028-3
Online ISBN: 978-1-84628-146-4
eBook Packages: MedicineMedicine (R0)