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

• Published in: European heart journal Vol. 28; no. 15; p. 1968
• Main Authors: Van Mieghem CA, Thury, A, Meijboom, W B, Cademartiri, F, Mollet, N R, Weustink, A C, Sianos, G, de Jaegere PP, Serruys, P W, de Feyter P
• Format: Journal Article
• Language: English
• Published: Oxford Oxford Publishing Limited (England) 01.08.2007
• ISSN: 0195-668X; 1522-9645

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 >or=2 mm in diameter were evaluated for the presence of a significant (>or=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.