Detection and characterization of coronary bifurcation lesions with 64-slice computed tomography coronary angiography

Carlos A.G. Van Mieghem, Attila Thury, Willem B. Meijboom, Filippo Cademartiri, Nico R. Mollet, Annick C. Weustink, Georgios Sianos, Peter P.T. De Jaegere, Patrick W. Serruys, Pim De Feyter

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Abstract

Aims: To compare the performance of 64-slice computed tomography coronary angiography (CTCA) and invasive coronary angiography (ICA) in the detection and classification (according to the Medina system) of bifurcation lesions (BLs). Methods and results: We studied 323 consecutive patients undergoing 64-slice CTCA prior to ICA. All coronary segments ≥2 mm in diameter were evaluated for the presence of a significant (≥50% diameter reduction on quantitative coronary angiography) BL. Evaluation of BL by CTCA included the assessment of significant lumen obstruction in both main and side branch vessels. Forty-one out of 43 patients (46/48 lesions) with significant BL were identified by CTCA. Excluding coronary segments with non-diagnostic image quality (5%), the sensitivity, specificity, and positive and negative predictive values of CTCA for detecting significant BL were 96, 99, and 85 and 99%, respectively. In 39 of these 41 patients, CTCA assessment was concordant with the Medina lesion classification on ICA. Conclusion: Sixty-four-slice CTCA allows accurate assessment of complex BL.

Original languageEnglish
Pages (from-to)1968-1976
Number of pages9
JournalEuropean heart journal
Volume28
Issue number16
DOIs
Publication statusPublished - Aug 1 2007

Keywords

  • Bifurcations
  • Computed tomography coronary angiography
  • Coronary atherosclerosis
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Van Mieghem, C. A. G., Thury, A., Meijboom, W. B., Cademartiri, F., Mollet, N. R., Weustink, A. C., Sianos, G., De Jaegere, P. P. T., Serruys, P. W., & De Feyter, P. (2007). Detection and characterization of coronary bifurcation lesions with 64-slice computed tomography coronary angiography. European heart journal, 28(16), 1968-1976. https://doi.org/10.1093/eurheartj/ehm195