Kann das CT die Katheterangiografie für die Koronardiagnostik ersetzen? – Nein!

Abstract

The need for coronary computed tomography (CTA) is still a matter of discussion. Areas in which CTA can replace invasive coronary angiography are rare. More data is needed to precise in which clinical settings CTA might be beneficial.

Trotz technischer Fortschritte bleibt das Indikationsgebiet für eine koronare Computertomografie sehr begrenzt. Hauptnachteil der computertomografischen Angiografie (CTA) ist die fehlende Option der Intervention. Zudem fehlt es an Studiendaten, die einen engen Praxisbezug zeigen.

Schlüsselwörter

Koronarangiographie - Computertomographie - perkutane Intervention

Key words

coronary angiography - computed tomography - percutaneous intervention

• Literatur

• 1 Vanhoenacker PK, Heijenbrok-Kal MH, Van Heste R. et al. Diagnostic performance of multidetector CT angiography for assessment of coronary artery disease: meta-analysis. Radiology 2007; 244: 419-28
• 2 Groves EM, Seto AH, Kern MJ. Invasive testing for coronary artery disease: FFR, IVUS, OCT, NIRS. Cardiology clinics 2014; 32: 405-17
• 3 Budoff MJ, Dowe D, Jollis JG. et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. Journal of the American College of Cardiology 2008; 52: 1724-32
• 4 Gibbons RJ, Balady GJ, Bricker JT. et al. ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Journal of the American College of Cardiology 2002; 40: 1531-40
• 5 Diamond GA. Right answer, wrong question: on the clinical relevance of the cardiovascular history. Circulation 2011; 124: 2377-2379
• 6 Hamm CW, Albrecht A, Bonzel T. et al. [Diagnostic heart catheterization]. Clinical research in cardiology: official journal of the German Cardiac Society 2008; 97: 475-512
• 7 Douglas PS, Hoffmann U, Patel MR. et al. Outcomes of anatomical versus functional testing for coronary artery disease. The New England journal of medicine 2015; 372: 1291-1300
• 8 Szummer K, Lundman P, Jacobson SH. et al. Influence of renal function on the effects of early revascularization in non-ST-elevation myocardial infarction: data from the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART). Circulation 2009; 120: 851-858
• 9 Ayaram D, Bellolio MF, Murad MH. et al. Triple rule-out computed tomographic angiography for chest pain: a diagnostic systematic review and meta-analysis. Academic emergency medicine: official journal of the Society for Academic Emergency Medicine 2013; 20: 861-871
• 10 Dweck MR, Williams MC, Moss AJ. et al. Computed Tomography and Cardiac Magnetic Resonance in Ischemic Heart Disease. Journal of the American College of Cardiology 2016; 68: 2201-2216
• 11 Giesler T, Baum U, Ropers D. et al. Noninvasive visualization of coronary arteries using contrast-enhanced multidetector CT: influence of heart rate on image quality and stenosis detection. Am J Roentgenol American journal of roentgenology 2002; 179: 911-916
• 12 Kroft LJ, de Roos A, Geleijns J. Artifacts in ECG-synchronized MDCT coronary angiography. Am J Roentgenol American journal of roentgenology 2007; 189: 581-591