On-Site Computed Tomography Versus Angiography Alone to Guide Coronary Stent Implantation: A Prospective Randomized Study

The effect of intraprocedural coronary computed tomography angiography (coronary CTA) guidance on percutaneous coronary intervention (PCI) is unknown. We sought to determine the influence of CTA guidance on procedural strategies and immediate angiographic outcomes of PCI. Sixty patients were randomi...

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Bibliographic Details
Published in:The Journal of invasive cardiology 2020-11, Vol.32 (11), p.E268-E276
Main Authors: Opolski, Maksymilian P, Schumacher, Stefan P, Verouden, Niels J W, van Diemen, Pepijn A, Borucki, Bartosz A, Sprengers, Ralf, Everaars, Henk, de Winter, Ruben W, van Rossum, Albert C, Nap, Alexander, Bom, Michiel J, Knaapen, Paul
Format: Article
Language:English
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Summary:The effect of intraprocedural coronary computed tomography angiography (coronary CTA) guidance on percutaneous coronary intervention (PCI) is unknown. We sought to determine the influence of CTA guidance on procedural strategies and immediate angiographic outcomes of PCI. Sixty patients were randomized to CTA-guided PCI (29 patients, 36 lesions) or angiography-guided PCI (31 patients, 39 lesions). To enable hands-free manipulation of CTA images by the interventional cardiologist during PCI, we developed an onsite augmented-reality (AR) system comprising a mobile application and AR glass. The primary endpoints were defined as: (1) stent length; and (2) largest stent diameter according to compliance chart. Procedural strategies, two-dimensional (2D) and three-dimensional (3D) quantitative coronary angiography (QCA), and safety outcomes were compared. Whereas CTA guidance resulted in significantly higher frequency of stent postdilation using non-compliant (67% vs 31%; P
ISSN:1557-2501
DOI:10.7306/GQ.1614