“CT scanners have to become interventionally savvy,” says Dr. John Carroll, Chief of Cardiology, Director of Interventional Cath Labs and Cardiac and Vascular Center at the University of Colorado Hospital. “They have to start giving us the anatomical information we need to plan an intervention.”
And he believes that with current CT technology and some focused R&D that can happen.
A logical approach
CT is emerging as a valuable diagnostic modality for patients with cardiac problems. Good vessel anatomy and lesion characteristics using non-invasive CT coronary angiography has been well demonstrated.
Dr Carroll contends that once a lesion is discovered using CT, that same modality can play an important role in subsequent revascularization therapy. He notes, “I’m able to get information from the CT that might enhance the planning and the execution of an intervention. CT gives me information I can’t get from a traditional invasive coronary angiogram.”
3D - Coronary Artery
Developing the tools
The question for Dr. Carroll is how to make use of the CT information available so as not to repeat a similar study in the cath lab that exposes the patient to additional radiation and contrast. “We need a CT based analysis package that would easily extract things like:
The size and shape of the aorta
The length and curvature of the coronary artery going down to the lesion
The degree to which the pathway is rigid (is there any calcium?)
Is the lesion calcified?
How long is the lesion?”
Dr. Carroll’s team at University of Colorado Hospital is working alongside Philips scientists to develop this package and validate this hypothesis.
A winning team
A new Philips Brilliance 40-slice CT has just been installed at University of Colorado Hospital’s new Fitzsimmons campus in Denver, Colorado. This unit is slated predominantly for cardiovascular work and will be used in this research. But why did they choose Philips?
Dr. Carroll explains, “The spatial and temporal resolution inherent in the 40-slice Brilliance unit makes much of this work feasible. But what impresses me most is Philips’ commitment to developing practical analysis software. That’s what really is important to an interventional cardiologist.”
Better planning, better outcome
Percutaneous coronary intervention (PCI) is not without inherent danger. For example, a catheter moving through a plaque filled aorta runs the risk of initiating a stroke. So getting the very best information for proper planning is critical.
Working with Philips CT and Cath Lab engineers and scientists, the team at University of Colorado Hospital is aspiring toward that goal. “I expect it will become routine for the majority of patients requiring initial anatomical definition of their coronary artery tree to go the CT route,” says Dr. Carroll. “And once there, we will be able to efficiently plan safer and faster interventions for those patients who need it.”
University of Colorado Hospital and Philips Medical Systems – working toward a common purpose – improved patient outcome.