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Review
. 2025 Jan 16;12(1):28.
doi: 10.3390/jcdd12010028.

Computed Tomography Angiography in the Catheterization Laboratory: A Guide Towards Optimizing Coronary Interventions

Eirini Beneki  1 , Kyriakos Dimitriadis  1 , Nikolaos Pyrpyris  1 , Alexios Antonopoulos  1 , Konstantinos Aznaouridis  1 , Panagiotis Antiochos  2 , Christos Fragoulis  1 , Henri Lu  2 , David Meier  2 , Konstantinos Tsioufis  1 , Stephane Fournier  2 , Constantina Aggeli  1 , Georgios Tzimas  2
Affiliations
Review

Computed Tomography Angiography in the Catheterization Laboratory: A Guide Towards Optimizing Coronary Interventions

Eirini Beneki et al. J Cardiovasc Dev Dis. .

Abstract

Cardiac computed tomography (CT) has become an essential tool in the pre-procedural planning and optimization of coronary interventions. Its non-invasive nature allows for the detailed visualization of coronary anatomy, including plaque burden, vessel morphology, and the presence of stenosis, aiding in precise decision making for revascularization strategies. Clinicians can assess not only the extent of coronary artery disease but also the functional significance of lesions using techniques like fractional flow reserve (FFR-CT). By providing comprehensive insights into coronary structure and hemodynamics, cardiac CT helps guide personalized treatment plans, ensuring the more accurate selection of patients for percutaneous coronary interventions or coronary artery bypass grafting and potentially improving patient outcomes.

Keywords: atherosclerosis; computed tomography; coronary angiography; coronary plaque; percutaneous coronary intervention; pre-procedural planning.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Artificial intelligence–enabled quantitative coronary plaque analysis (AI-QCPA) on coronary computed tomography angiography (CCTA). Blue-colored areas are calcified plaque, and yellow-colored areas are noncalcified plaque in the left anterior descending (LAD) coronary artery. The pink arrows of the longitudinal view (right) correspond to the specific corresponding cross-sectional view. CT images were analyzed using commercially available post-processing software iNtuition v4.4.13 (TeraRecon, Foster City, CA, USA).
Figure 2
Figure 2
Coronary computed tomography angiography (CCTA) demonstrating 70–90% stenosis in the right coronary artery (RCA). A solid arrow indicates calcified plaque, while a blue triangular arrow highlights non-calcified plaque. A short-axis image (white dashed line) obtained using double oblique reconstruction shows plaque with high-risk features (napkin-ring sign).
Figure 3
Figure 3
Coronary computed tomography angiography (CCTA) reveals severe stenosis in the mid-segment of the right coronary artery (RCA). (A) Red lines indicate the minimum diameter, and blue lines represent the maximum diameter of the proximal reference vessel. (B) Red lines show the minimum diameter, and blue lines indicate the maximum diameter of the distal reference vessel. A–B represents the lesion length. Volume-rendered CCTA images with fluoroscopic angles showing RCA stenosis: (C) RAO 30°, CRA 10°; (D) LAO 30°, CRA 0°. RAO: right anterior oblique; CRA: cranial; LAO: left anterior oblique.
Figure 4
Figure 4
CT-derived fractional flow reserve (FFR-CT) model in the setting of a moderate proximal right coronary artery (RCA) lesion with an FFR-CT value of 0.64 at the distal RCA. FFR-CT analysis shows an abnormal translesional physiology in the distal left ascending aorta (LAD) due to a coronary lesion, with an FFR-CT value of 0.63 at the distal LAD.
See this image and copyright information in PMC

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