Scholarlink

<p>Fractional flow reserve (FFR) post percutaneous coronary intervention (PCI) is an important determinant of patient outcomes. A new virtual stent planning tool allows users to model PCI and obtain post PCI FFR<sub>CT</sub>. We hypothesised that where a sub-optimal post PCI FFR<sub>CT</sub> was predicted theoretical management may be altered prior to invasive angiography. Single-centre retrospective review of patients listed for PCI with preceding CTCA(+ FFR<sub>CT</sub>), (Jan 2023-Sep 2024). Interventional cardiologists (ICs) at our institution determined a theoretical management strategy of (1) medical therapy (GDMT) (2) PCI or (3) multi-disciplinary team meeting (MDT) ± coronary artery bypass grafting (CABG) on a per-patient and per-vessel basis. The virtual stent planning tool was then unblinded and decision making repeated. Changes to management were compared with Wilcoxon-signed rank test and inter-rater agreement with Fleiss’ free marginal kappa. 335 patients had a CTCA(+ FFR<sub>CT</sub>), 96 clinically listed for angiography, 74 included in the study. 73% male, 66 ± 11 years. On a per-patient basis using CTCA(+ FFR<sub>CT</sub>) data PCI was chosen in 95% of cases, GDMT in 4% and MDT ± CABG in 1%. The addition of the virtual planning tool changed management strategy to PCI in 59% of cases, GDMT in 30% and MDT in 11%, Wilcoxon-signed rank test <i>P</i> = 0.04. In patients scheduled to undergo clinically indicated PCI with preceding CTCA(+ FFR<sub>CT</sub>) the use of the virtual stent planning tool significantly altered ICs theoretical management strategy upstream of invasive angiography, with a reduction in PCI, predominantly in favour of GDMT.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of an interactive CTCA/FFRCT interventional stent planning tool on patient management

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年7月19日

查看全文
  • David Murphy,
  • Anil Gurung,
  • Daniel McKenzie,
  • Robert Lowe,
  • Sri Raveen Kandan,
  • Thomas Burchell,
  • Kevin Carson,
  • Ali Khavandi,
  • Jonathan C. L. Rodrigues,
  • JCL Rodrigues

摘要

Fractional flow reserve (FFR) post percutaneous coronary intervention (PCI) is an important determinant of patient outcomes. A new virtual stent planning tool allows users to model PCI and obtain post PCI FFRCT. We hypothesised that where a sub-optimal post PCI FFRCT was predicted theoretical management may be altered prior to invasive angiography. Single-centre retrospective review of patients listed for PCI with preceding CTCA(+ FFRCT), (Jan 2023-Sep 2024). Interventional cardiologists (ICs) at our institution determined a theoretical management strategy of (1) medical therapy (GDMT) (2) PCI or (3) multi-disciplinary team meeting (MDT) ± coronary artery bypass grafting (CABG) on a per-patient and per-vessel basis. The virtual stent planning tool was then unblinded and decision making repeated. Changes to management were compared with Wilcoxon-signed rank test and inter-rater agreement with Fleiss’ free marginal kappa. 335 patients had a CTCA(+ FFRCT), 96 clinically listed for angiography, 74 included in the study. 73% male, 66 ± 11 years. On a per-patient basis using CTCA(+ FFRCT) data PCI was chosen in 95% of cases, GDMT in 4% and MDT ± CABG in 1%. The addition of the virtual planning tool changed management strategy to PCI in 59% of cases, GDMT in 30% and MDT in 11%, Wilcoxon-signed rank test P = 0.04. In patients scheduled to undergo clinically indicated PCI with preceding CTCA(+ FFRCT) the use of the virtual stent planning tool significantly altered ICs theoretical management strategy upstream of invasive angiography, with a reduction in PCI, predominantly in favour of GDMT.