Abstract 3828: Assessment of Coronary Bifurcation Lesions with 64-slice Computed Tomography Coronary Angiography
Aims: To evaluate the diagnostic value of 64-slice computed tomography coronary angiography (CTCA) for the assessment of coronary bifurcation lesions (BLs) and to assess extent of disease comparing invasive coronary angiography (ICA) with CTCA with the use of a bifurcation lesion classification system.
Methods and results: We studied 313 consecutive patients who underwent 64-slice CTCA prior to ICA. All coronary segments larger than 2 mm in diameter were evaluated for the presence of significant BLs (≥50% diameter reduction as defined by quantitative coronary angiography). Evaluation of BLs by CTCA included assessment for significant lumen obstruction and presence of non-obstructive plaque. We compared the findings of ICA with those of CTCA using a simplebifurcation-lesion classification system. Forty-two out of 44 patients (46/48 lesions) with significant BLs were identified by CTCA. The sensitivity, specificity, positive and negative predictive values of CTCA for detecting significant BLs was 96, 99, 85 and 99% respectively. In 40 of these 42 patients, CTCA correctly reproduced the luminal classification of the main vessel and side branch as assessed with ICA. ICA systematically underestimated the extent of disease in significant BLs since non-obstructive plaque proved to be present in the majority of the patients when assessed with CTCA.
Conclusion: 64-slice CTCA allows accurate assessment of bifurcation lesions, including lumen and wall abnormalities.