CTA finds lesions missed by catheter angiography

CT angiography can identify patients with subclinical atherosclerosis who may be inaccurately diagnosed as normal by traditional catheter angiography, according to a study at the 2004 North American Society for Cardiac Imaging meeting.

Jeffrey J. Fine and Dr. Richard A. Edelson of the South Carolina Heart Center in Columbia used 16-slice CTA to evaluate 40 consecutive patients within seven days after they had a normal diagnostic catheterization.

CTA identified eight patients with nonobstructive blockages in the left anterior descending artery (75% were calcific lesions and 25% soft plaque). Additionally, two of those eight had nonobstructive calcific blockages in the circumflex artery, and four had nonobstructive calcific blockages in the right coronary artery.

Although catheter angiography is the standard of reference for diagnostic angiography, it produces a 2D image with limited outer vessel visualization, preventing the identification of specific lesion types, Fine said.