The Emerging Role of Computed Tomography Coronary Angiography in the Left Main Stem Percutaneous Coronary Intervention
Recent advancements in computed tomography have significantly transformed the clinical application of this technique in diagnosing and managing coronary artery disease (CAD). Computed tomography coronary angiography (CTCA) has emerged as a leading non-invasive imaging modality, often serving as the...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
IMR Press
2025-05-01
|
| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM37379 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849471668235272192 |
|---|---|
| author | Asad Shabbir Abdelrahman Attia Nikkole Marie Weber Mustafa Alhassan Monika Radike Conor M Lane Apurva Bhavana Challa Malgorzata Wamil |
| author_facet | Asad Shabbir Abdelrahman Attia Nikkole Marie Weber Mustafa Alhassan Monika Radike Conor M Lane Apurva Bhavana Challa Malgorzata Wamil |
| author_sort | Asad Shabbir |
| collection | DOAJ |
| description | Recent advancements in computed tomography have significantly transformed the clinical application of this technique in diagnosing and managing coronary artery disease (CAD). Computed tomography coronary angiography (CTCA) has emerged as a leading non-invasive imaging modality, often serving as the first-line investigation to exclude obstructive CAD in patients with chronic coronary syndrome. Beyond its utility in diagnosing CAD, CTCA has become instrumental in procedural planning for percutaneous coronary intervention (PCI), particularly in complex cases such as left main stem (LMS) interventions, where peri-procedural risks are elevated. This review highlights the evolving role of CTCA in LMS PCI, underscoring its clinical utility in improving procedural precision and, subsequently, patient outcomes. Recent technological advancements, including detailed multiplanar and three-dimensional (3D) reconstructions, CT-derived fractional flow reserve (CTFFR), and the integration of artificial intelligence (AI) algorithms, have expanded the capabilities of CTCA. These innovations allow for comprehensive anatomical and functional assessments, enabling precise plaque morphology, lesion complexity, and bifurcation anatomy evaluations alongside PCI simulations. By offering detailed insights into coronary vasculature and lesion characteristics, CTCA provides critical information for optimising LMS PCI strategies. This review explores the current applications and future potential of CTCA in guiding LMS PCI, highlighting its role in improving procedural planning, risk assessment, and overall management of this challenging patient population. |
| format | Article |
| id | doaj-art-e983838fd95642ae971f6ed579d9adb2 |
| institution | Kabale University |
| issn | 1530-6550 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj-art-e983838fd95642ae971f6ed579d9adb22025-08-20T03:24:44ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-05-012653737910.31083/RCM37379S1530-6550(25)01822-8The Emerging Role of Computed Tomography Coronary Angiography in the Left Main Stem Percutaneous Coronary InterventionAsad Shabbir0Abdelrahman Attia1Nikkole Marie Weber2Mustafa Alhassan3Monika Radike4Conor M Lane5Apurva Bhavana Challa6Malgorzata Wamil7John Radcliffe Hospital, Oxford University Hospitals, OX3 9DU Oxford, UKCardiology Department, Great Western Hospital NHS Trust, SN3 6BB Swindon, UKRadiology Department, Mayo Clinic Rochester, Rochester, MN 55903, USACardiology Department, Great Western Hospital NHS Trust, SN3 6BB Swindon, UKRadiology Department, Mayo Clinic Rochester, Rochester, MN 55903, USARadiology Department, Mayo Clinic Rochester, Rochester, MN 55903, USARadiology Department, Mayo Clinic Rochester, Rochester, MN 55903, USACardiology Department, Great Western Hospital NHS Trust, SN3 6BB Swindon, UKRecent advancements in computed tomography have significantly transformed the clinical application of this technique in diagnosing and managing coronary artery disease (CAD). Computed tomography coronary angiography (CTCA) has emerged as a leading non-invasive imaging modality, often serving as the first-line investigation to exclude obstructive CAD in patients with chronic coronary syndrome. Beyond its utility in diagnosing CAD, CTCA has become instrumental in procedural planning for percutaneous coronary intervention (PCI), particularly in complex cases such as left main stem (LMS) interventions, where peri-procedural risks are elevated. This review highlights the evolving role of CTCA in LMS PCI, underscoring its clinical utility in improving procedural precision and, subsequently, patient outcomes. Recent technological advancements, including detailed multiplanar and three-dimensional (3D) reconstructions, CT-derived fractional flow reserve (CTFFR), and the integration of artificial intelligence (AI) algorithms, have expanded the capabilities of CTCA. These innovations allow for comprehensive anatomical and functional assessments, enabling precise plaque morphology, lesion complexity, and bifurcation anatomy evaluations alongside PCI simulations. By offering detailed insights into coronary vasculature and lesion characteristics, CTCA provides critical information for optimising LMS PCI strategies. This review explores the current applications and future potential of CTCA in guiding LMS PCI, highlighting its role in improving procedural planning, risk assessment, and overall management of this challenging patient population.https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM37379computed tomography coronary angiographycomputed tomography derived fractional flow reserveleft main stem percutaneous coronary interventioncoronary artery diseaseplaque characterisation |
| spellingShingle | Asad Shabbir Abdelrahman Attia Nikkole Marie Weber Mustafa Alhassan Monika Radike Conor M Lane Apurva Bhavana Challa Malgorzata Wamil The Emerging Role of Computed Tomography Coronary Angiography in the Left Main Stem Percutaneous Coronary Intervention Reviews in Cardiovascular Medicine computed tomography coronary angiography computed tomography derived fractional flow reserve left main stem percutaneous coronary intervention coronary artery disease plaque characterisation |
| title | The Emerging Role of Computed Tomography Coronary Angiography in the Left Main Stem Percutaneous Coronary Intervention |
| title_full | The Emerging Role of Computed Tomography Coronary Angiography in the Left Main Stem Percutaneous Coronary Intervention |
| title_fullStr | The Emerging Role of Computed Tomography Coronary Angiography in the Left Main Stem Percutaneous Coronary Intervention |
| title_full_unstemmed | The Emerging Role of Computed Tomography Coronary Angiography in the Left Main Stem Percutaneous Coronary Intervention |
| title_short | The Emerging Role of Computed Tomography Coronary Angiography in the Left Main Stem Percutaneous Coronary Intervention |
| title_sort | emerging role of computed tomography coronary angiography in the left main stem percutaneous coronary intervention |
| topic | computed tomography coronary angiography computed tomography derived fractional flow reserve left main stem percutaneous coronary intervention coronary artery disease plaque characterisation |
| url | https://www.imrpress.com/journal/RCM/26/5/10.31083/RCM37379 |
| work_keys_str_mv | AT asadshabbir theemergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT abdelrahmanattia theemergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT nikkolemarieweber theemergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT mustafaalhassan theemergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT monikaradike theemergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT conormlane theemergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT apurvabhavanachalla theemergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT malgorzatawamil theemergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT asadshabbir emergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT abdelrahmanattia emergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT nikkolemarieweber emergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT mustafaalhassan emergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT monikaradike emergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT conormlane emergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT apurvabhavanachalla emergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention AT malgorzatawamil emergingroleofcomputedtomographycoronaryangiographyintheleftmainstempercutaneouscoronaryintervention |