Olivier Ghekiere MD, Presenter: Nothing to Disclose

Willem Dewilde, Abstract Co-Author: Nothing to Disclose

Tim Coolen, Abstract Co-Author: Nothing to Disclose

Roland Materne MD, Abstract Co-Author: Nothing to Disclose

Isabelle Mancini, Abstract Co-Author: Nothing to Disclose

Alain Nchimi MD, Abstract Co-Author: Nothing to Disclose

Julien Djekic, Abstract Co-Author: Nothing to Disclose

Thierry Couvreur MD, Abstract Co-Author: Nothing to Disclose

Michel Bellekens MD, Abstract Co-Author: Nothing to Disclose

To evaluate the distribution of findings at quantitative coronary angiography and fractional flow reserve (FFR) among arteries with intermediate coronary artery stenoses (ICAS) at coronary CT angiography.

Between August 2009 and February 2011, 36 patients (27 M, 9 F; mean age: 62.4 ± 10.3 y; range:44-82 y) with 50 ICAS at coronary CT angiography were prospectively enrolled in this study. ICAS at coronary CT angiography was defined as 40-70% minimal diameter reduction on >2mm diameter vessels after consensus reading by 2 experienced readers. Quantitative coronary angiography with minimal diameter reduction percentage measurement of all stenoses was then obtained within 4 weeks after coronary CT angiography and the lesions were classified as non-significant (70%). Intermediate stenosis at quantitative coronary angiography underwent FFR measurement, recorded as the ratio post/pre-stenotic pressure after papaverine injection. Significant stenoses were finally defined as either >70% diameter reduction at quantitative coronary angiography or ≤70% diameter reduction at quantitative coronary angiography and FFR <0.80.

At quantitative coronary angiography, stenoses were non-significant in 28% (14/50), intermediate in 58% (29/50), and significant in 14% (7/50). The average FFR value was 0.81 ± 0.08 in the 29 arteries with intermediate stenosis at quantitative coronary angiography. FFR values were 0.80 in 52% (15/29). Therefore, a total number of 21/50 ICAS at coronary CT angiography were defined as significant stenoses after quantitative coronary angiography and FFR.

Almost half of ICAS diagnosed at coronary CT angiography are either significant at quantitative coronary angiography or flow-limiting.

ICAS are common at coronary CT angiography. The prevalence of significant stenosis in this group suggests using noninvasive gatekeepers before invasive procedures.

Ghekiere, O, Dewilde, W, Coolen, T, Materne, R, Mancini, I, Nchimi, A, Djekic, J, Couvreur, T, Bellekens, M, Invasive Evaluation of Coronary Arteries with Intermediate Stenosis at Coronary CT Angiography: Prevalence of Significant Findings.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11009728.html