Conventional invasive coronary angiography is currently the diagnostic standard for clinical evaluation of known or suspected coronary artery disease (CAD), according to background information in the article. The risk of adverse events is small, but serious and potentially life-threatening events may occur, including arrhythmia, stroke, coronary artery dissection, and access site bleeding (total complication rate, 1.8 percent; death rate, 0.1 percent). Furthermore, angiography catheterization induces some discomfort and mandates routine follow-up care. Guidelines recommend that conventional invasive diagnostic angiography be restricted to stringent clinical indications.
A recently developed procedure that may potentially complement invasive coronary angiography is multislice computed tomography (MSCT), which may achieve a high level of reliability and accuracy in the visualization of the coronary arteries. MSCT is a sophisticated x-ray imaging technique, in which a CT tube and multiple layered detector rows rotate around the patient, taking numerous images of the body in seconds. A computer processes this information into three-dimensional images composing volumetric representations of anatomy. The coronary arteries can be extracted from these images and are presented in arbitrarily oriented sectional cuts. This procedure eliminates much of the risk and discomfort associated with invasive coronary artery catheterization, although it retains the risks inherent in radiation exposure and use of contrast agents.
Martin H. K. Hoffmann, M.D., of University Hospital, Ulm, Germany and colleagues assessed the diagnostic accuracy of 16-slice MSCT scanning vs. invasive coronary angiography in a large group of patients with kno
Contact: Martin H. K. Hoffmann, M.D.
JAMA and Archives Journals