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Congress: ECR25
Poster Number: C-17773
Type: Poster: EPOS Radiologist (scientific)
Authorblock: C. Bini, A. Lupi, G. Galia, R. Bianco, E. Quaia, G. Gerosa, A. Pepe; Padua/IT
Disclosures:
Costanza Bini: Nothing to disclose
Amalia Lupi: Nothing to disclose
Giuliana Galia: Nothing to disclose
Roberto Bianco: Nothing to disclose
Emilio Quaia: Nothing to disclose
Gino Gerosa: Nothing to disclose
Alessia Pepe: Nothing to disclose
Keywords: Cardiac, Radioprotection / Radiation dose, CT-Angiography, Radiation safety, Socio-economic issues, Dosimetric comparison, Economics, Occupational / Environmental hazards, Sustainability
Purpose Coronary artery disease (CAD) commonly develops owing to the formation of plaques within the walls of the coronary arteries, which reduces blood flow and can lead to serious complications such as myocardial ischemia and infarction [1].Based on the current recommendations, patients with cardiac risk candidate for cardiac and noncardiac surgery at intermediate-high risk are sent to invasive coronary angiography (ICA) (I class indication) for assessing CAD [2,3]. The indication to Coronary Computed Tomography (CCT) is growing as a promising alternative...
Read more Methods and materials In this study, we prospectively enrolled patients referred to our Radiology Institute, Department of Medicine DIMED – Padua University Hospital, to perform a CCT before surgery between December 2021 and February 2024. The subjects underwent an ECG-gated 128-slices GE revolution CCT examination. Acquisition was performed after bradycardization with e.v. metoprolol and sublingual isosorbide dinitrate administration. Calcium score (CA) was acquired in all patients.Exclusion criteria were (1) high coronary calcium score (> 2065 for men and > 1377 for women), which...
Read more Results Eighty-five patients were finally included, 52 males, mean age 61±13 years. All CCT scans were diagnostic, without recorded complications. Twenty-one patients (25%) showed no stenosis (CAD-RADS 0) and CA 0, eighteen (21%) had minimal stenosis (CAD-RADS 1) and CA 36 ± 59, and nineteen (22%) had mild stenosis (CAD-RADS 2) and CA 240 ± 309.Nineteen (22%) patients showed moderate stenosis (CAD-RADS 3) and CA 545 ± 386, of these 2 underwent stress Cardiac Magnetic Resonance (CMR), one of them with positive...
Read more Conclusion In the pre-operative patients, the non-invasive CCT strategy for the CAD assessment is feasible and it reduces significantly the number of ICA procedures. The non-invasive CCT strategy reduces significantly the costs, radio exposure and CO2 emissions. The adoption of this non-invasive preoperative strategy proves advantageous not only clinically, but also economically, radiologically and from an environmental point of view, offering a safer and more sustainable model of care.LimitationThis is a single-center prospective survey, which could inherently introduce a center-specific bias....
Read more References Shahjehan, Rai Dilawar, et al. Coronary Artery Disease. StatPearls 2024.   Halvorsen S, et al. 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery. European Heart Journal 2022. Vahanian A, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal 2022. Lorenzoni V, et al. 2019 Cost-effectiveness analysis of stand-alone or combined non-invasive imaging tests for the diagnosis of stable coronary artery disease: results from the EVINCI study. The European Journal of Health Economics...
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