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Background <p>Coronary CT Angiography (CTA) is increasingly being used to plan percutaneous coronary intervention (PCI), offering detailed pre-procedural anatomical and physiological insights. The Precise Procedural and PCI Plan (P4) study evaluates the efficacy of CT- versus intravascular ultrasound-guided PCI. The aim of this study was to assess the utility of various CT-guided PCI tools and strategies as perceived by experienced operators within the context of the P4 study.</p> Methods <p>A cross-sectional survey was conducted among 25 operators who participate in the P4 trial from multiple international centers. Participants were asked to evaluate the utility of pre-procedural CTA planning, physiological information with virtual PCI, and online guidance. The survey included multiple-choice, Likert scale, and ranking questions.</p> Results <p>Most respondents valued pre-procedural planning highly (average score 2.83/3), particularly for the assessment of plaque composition and calcium characterization. Plaque composition evaluation, including calcium analysis, was ranked as the most valued factor, with an average usefulness score of 6.13/7. Calcium arc information was rated as the most useful component of calcium analysis (4/5 rating). The survey highlighted the importance of myocardial mass at risk assessment in bifurcation PCI and pointed to the anticipation of calcium density as a key future aspect of CT-guided PCI procedures.</p> Conclusions <p>The integration of CT-guided PCI promises to refine procedural planning and to pave the way for a new standard of care in patients with stable CAD.</p>

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Clinical utility of coronary CT angiography to guide PCI: a survey among P4 investigators

  • 期刊论文

  • 发表日期：

    2025年2月19日

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  • Nikolaos Stalikas,
  • Frederic Bouisset,
  • Takuya Mizukami,
  • Atomu Tajima,
  • Daniel Munhoz,
  • Kazumaza Ikeda,
  • Jeroen Sonck,
  • Eric Wyffels,
  • Adriaan Wilgenhof,
  • Patricio Astudillo,
  • Daniela Trabattoni,
  • Piero Montorsi,
  • Carlo Zivelonghi,
  • Pierfranscesco Agostoni,
  • Benjamin Scott,
  • Paul Vermeersch,
  • Emanuele Gallinoro,
  • Giovanni Monizzi,
  • Daniele Andreini,
  • Bert Vandeloo,
  • Stijn Lochy,
  • Jean-francois Argacha,
  • Nicolaj Brejnholt Støttrup,
  • Michael Maeng,
  • Thomas Engstrøm,
  • Ketina Arslani,
  • Niels Thue Olsen,
  • Hirohiko Ando,
  • Tetsuya Amano,
  • Hirofumi Ohashi,
  • Allen Jeremias,
  • Ziad Ali,
  • Evan Shlofmitz,
  • Koshiro Sakai,
  • James C. Spratt,
  • Emmanouil S. Brilakis,
  • Yader Sandoval,
  • Giulio Stefanini,
  • Alan Bagnall,
  • Ian Purcell,
  • István Ferenc Edes,
  • Bernard De Bruyne,
  • Carlos Collet

摘要

Background

Coronary CT Angiography (CTA) is increasingly being used to plan percutaneous coronary intervention (PCI), offering detailed pre-procedural anatomical and physiological insights. The Precise Procedural and PCI Plan (P4) study evaluates the efficacy of CT- versus intravascular ultrasound-guided PCI. The aim of this study was to assess the utility of various CT-guided PCI tools and strategies as perceived by experienced operators within the context of the P4 study.

Methods

A cross-sectional survey was conducted among 25 operators who participate in the P4 trial from multiple international centers. Participants were asked to evaluate the utility of pre-procedural CTA planning, physiological information with virtual PCI, and online guidance. The survey included multiple-choice, Likert scale, and ranking questions.

Results

Most respondents valued pre-procedural planning highly (average score 2.83/3), particularly for the assessment of plaque composition and calcium characterization. Plaque composition evaluation, including calcium analysis, was ranked as the most valued factor, with an average usefulness score of 6.13/7. Calcium arc information was rated as the most useful component of calcium analysis (4/5 rating). The survey highlighted the importance of myocardial mass at risk assessment in bifurcation PCI and pointed to the anticipation of calcium density as a key future aspect of CT-guided PCI procedures.

Conclusions

The integration of CT-guided PCI promises to refine procedural planning and to pave the way for a new standard of care in patients with stable CAD.