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CTA combines best aspects of IVUS, invasive angiography
Technology excels in helping characterize plaque burden.
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CTA is useful for analyzing numerous characteristics of plaque that other techniques might miss.
According to a presentation given at the 3rd Annual Scientific Sessions of the Society for Cardiovascular Computed Tomography in Orlando, CTA possesses several unique abilities that can assist physicians in the task of locating, assessing and characterizing plaque within the cardiovascular system.
“Angiography grossly underestimates the presence and extent of the atherosclerosis,” James A. Goldstein, MD, director of research and education at William Beaumont Hospital in Royal Oak, Mich., said in his presentation. “It tells us nothing about the content of the plaque or about plaque biology. Computed tomography has the potential to tell us a lot about architecture as well as luminography.”
Goldstein noted that CTA provides a combination of benefits that other imaging techniques like invasive angiography and IVUS exhibit.
“Computed tomography is a beautiful technique because it provides a hybrid data set combining not only the luminography obtained by invasive angiography, but also IVUS-type data attributable to CTA tissue attenuation capabilities,” Goldstein said. “CTA can characterize the plaque burden, elucidate lesion architecture and remodeling, document calcification and delineate morphological features indicative of plaque disruption.”
The CT data obtained from characterizing different types of plaque, according to Goldstein, can help the physician determine not only the severity and prevalence of the atherosclerosis, but also whether the plaque is unstable and may potentially help predict the natural history of certain plaques. Together these data may help guide therapeutic interventions.
“To have better insight as to how best to treat our patients, we need to understand atherosclerotic burden, plaque architecture, remodeling index, fibrous cap thickness, biology and coronary flow,” Goldstein said. “Computed tomography angiography can clearly illuminate features of ruptured plaque and provides a hybrid 3-D snapshot, giving tremendous insight into the area of intramural atherosclerosis regarding the presences, extent and character of the plaque.”
For more information:
- Goldstein J. Current ACS Guidelines. Presented at: the 3rd Annual Scientific Sessions of the Society for Cardiovascular Computed Tomography; July 17-20, 2008; Orlando, Fla.