ISSN 1016-5169 | E-ISSN 1308-4488
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Discrepancy in Diagnosing Coronary Artery Occluded Lesion: CT-Derived Fractional Flow Reserve (FFRCT) Versus Invasive Coronary Angiography [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2024; 52(3): 208-212 | DOI: 10.5543/tkda.2023.29035

Discrepancy in Diagnosing Coronary Artery Occluded Lesion: CT-Derived Fractional Flow Reserve (FFRCT) Versus Invasive Coronary Angiography

Toshimitsu Tsugu1, Kaoru Tanaka1, Yuji Nagatomo2, Michel De Maeseneer1, Johan De Mey1
1Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
2Department of Cardiology, National Defense Medical College Hospital, Tokorozawa, Japan

Coronary computed tomography angiography (CCTA) and CT-derived fractional flow reserve (FFRCT) findings demonstrate high diagnostic accuracy, aligning consistently with invasive coronary angiography (ICA), the gold standard diagnostic technique for coronary artery disease. The differential diagnosis of total versus subtotal coronary occlusion is crucial in determining the appropriate treatment strategy. Subtotal coronary occlusions composed of vulnerable tissue can sometimes present as total coronary occlusions on ICA. This presentation can be inconsistent with findings from CCTA and FFRCT. This case report presents discrepant findings between CCTA, which indicated subtotal coronary occlusion, and ICA, which suggested total coronary occlusion. The stenotic lesion, filled with vulnerable tissue (low-attenuation plaque volume: 20.3 mm3 and intermediate-attenuation plaque volume: 71.6 mm3), could be dilated with a vasodilator during maximal hyperemia. This dilation facilitated the acquisition of CCTA and FFRCT images. We were able to diagnose subtotal coronary occlusion and identify the overall anatomical structure of the vessels prior to percutaneous coronary intervention (PCI). This allowed us to perform a successful and uncomplicated PCI.

Keywords: Coronary artery disease, coronary computed tomography angiography, total occlusion



















How to cite this article
Toshimitsu Tsugu, Kaoru Tanaka, Yuji Nagatomo, Michel De Maeseneer, Johan De Mey. Discrepancy in Diagnosing Coronary Artery Occluded Lesion: CT-Derived Fractional Flow Reserve (FFRCT) Versus Invasive Coronary Angiography. Turk Kardiyol Dern Ars. 2024; 52(3): 208-212

Corresponding Author: Toshimitsu Tsugu, Belgium
Manuscript Language: English


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