Comparison of Usefulness of Percutaneous Coronary Intervention Guided by Angiography plus Computed Tomography Versus Angiography Alone and its Impact on Instent Restenosis

Abstract

nvasive coronary angiography has been traditionally used for evaluation of the presence and severity of coronary artery disease. Accordingly, the technique has been extensively utilized to guide further treatment strategies, such as percutaneous coronary intervention with stent placement. PCI is the most common revascularization strategy for patients with symptomatic obstructive coronary artery disease. Procedural success is dependent on the accurate assessment of the target lesion and accurate stent selection. Coronary computed tomographic angiography (CCTA) is an emerging noninvasive imaging modality with good sensitivity and specificity for detecting obstructive CAD and plaque characteristics. Given its ability to assess coronary anatomy as well as nearby coronary plaque, it may have the ability to provide additional information to assist with stent selection. Accurate sizing of stents used during PCI is essential to avoid the instent restenosis and late stent thrombosis This study was done to assess the impact of incorporating CCTA guidance in defining reference value for stent length and diameter on angiographic and clinical outcomes in comparison to quantitative coronary angiography and its effect on incidence of instent restenosis. The study was conducted on 153 diabetic patients with stable coronary artery disease presented to cardiac catheterization laboratory at National Heart Institute and Sheikh Zayed Specia