Coronary CT Angiography (CCTA)
INTRODUCTION
The current gold standard for diagnosing and identifying patients at high risk of cardiovascular events is angiography: an invasive procedure involving a visit to the hospital catheter lab, where a catheter is threaded into the femoral artery and up to the heart to allow physicians a view of blockage in the coronary arteries.
Conventional angiography carries a small risk of adverse events, including bleeding, hematoma, infection, stroke, coronary artery dissection and death. In addition, although the procedure takes comparatively little time to perform, it requires patient fasting before the exam and hours of hospitalized recuperation after the exam.
Now, detection and follow-up of patients with coronary artery disease (CAD) has become more patient-friendly thanks to new advances in multi-detector computed tomography (MDCT). Coronary CT Angiography (CCTA) effectively rules in or rules out coronary atherosclerosis as well as many non-cardiac causes of chest pain, in a single, fast comprehensive exam.
CORONARY CT ANGIOGRAM – IMPORTANT REFERRAL INSTRUCTIONS
- patients should have one of the indications listed below
- please submit recent (within the past 90 days) ECG, Creatinine & GFR results
- please include relevant history and test results (including stress test)
Click here for referral form.
INDICATIONS FOR CORONARY CT ANGIOGRAPHY
- Atypical chest pain in a patient at risk for CAD
- Clarification of inconclusive non-invasive studies (i.e. suspected false-positive nuclear or exercise stress tests)
- Screening in high risk individuals when soft plaque is suspected and CACs score is low
- Interval evaluation of known CAD, in patients who have indeterminate symptoms
- Patients refusing conventional coronary angiography (denial, fear, prior negative experience)
- Known or suspected anomalous coronary arteries (complex anatomic relationships can be accurately depicted in 3D)
- Evaluation of bypass grafts and stents
- To exclude CAD in patients with impaired LV function
CONTRAINDICATIONS FOR CCTA (CONTRAST)
- Renal insufficiency (when GFR < 30 or IDDM patients < 60)
- Reactive airway disease (relative-use Verapamil)
- Severe COPD (Asthma, Emphysema, Chronic Bronchitis-steroids, intubation)
- Significant arrhythmias (especially atrial fibrillation)
- History of contrast allergy (rarely will premedicate such patients with steroids)
- Coronary artery calcium scores > 1000 (high calcium load causes artifact) If patient is in the >50%ile, then MIBI. If MIBI negative, then CCTA, if abnormal then cath
REPORTING
At Canada Diagnostic Centres, all Coronary CT Angiography scans will be read by a radiologist and a cardiologist. This partnership approach ensures the highest quality of image interpretation and patient management.
Click here for information on your CCTA appointment.
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HEALTH NEWS FLASH:
For more in-depth information on Coronary CT Angiography,
click here to view article:
Title: "CCTA: A Noninvasive Assessment of CAD"
Source: Perspectives in Cardiology; September 2006
Authors: Dr. Brett Heilbron and Dr. Bruce Forster
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CORONARY CT ANGIOGRAPHY
"Multislice computed tomography provides high accuracy for noninvasive detection of suspected obstructive coronary artery disease. This promising technology has potential to complement diagnostic invasive coronary angiography in routine
clinical care."
-Hoffman et al JAMA 2005; 293:2471-2478
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