Coronary computed tomography angiography (CCTA) has traditionally been employed for diagnostic purposes, however increasing evidence and real-world experience suggest that CCTA can be used for the pre-procedural planning of PCI and inform patient triage, shared decision-making, case complexity, and resource use.

CCTA-guided PCI is defined as a PCI procedure in which CCTA information is used to guide PCI planning through a detailed review of the CCTA images by the interventional cardiologist, either in collaboration with a cardiac imager or independently if trained in CCTA-guided PCI. Most patients undergoing a high-quality CCTA to evaluate chest pain or anginal equivalent symptoms according to clinical practice guidelines may have their existing imaging used for CCTA-guided PCI.

This manuscript represents considerations and consensus perspectives that emerged from a scientific roundtable discussion held on October 25, 2024, that included 17 US-based and international physician leaders with expertise in interventional cardiology and cardiac imaging. The roundtable's aims were to assess the current state of CCTA-guided PCI, focused on practical applications and key lesion subsets, identify barriers to optimal use, and create a framework for future action to improve care and outcomes for patients undergoing PCI.

Watch the Conversation

Drs. Leipsic, Sandoval, Nieman, Pinilla, and Garcia discuss key insights and takeaways from the recently published SCAI/SCCT scientific roundtable document on CCTA-Guided PCI. They explore using CCTA to enhance pre-procedural planning, improve patient outcomes, and optimize resource utilization by providing detailed anatomical and functional assessments of coronary lesions. They also discuss recommendations, including increasing access to contemporary CCTA, enhancing visualization tools for interventionalists, and promoting educational training efforts. 

All authors: Yader Sandoval, MD, FSCAI; Jonathon Leipsic, MD; Carlos Collet, MD, PhD; Ziad A. Ali, MD, DPhil, FSCAI; Lorenzo Azzalini, MD, PhD, MSc, FSCAI; Emanuele Barbato, MD, PhD; João L.  Cavalcante, MD, PhD; Ricardo A. Costa, MD, PhD; Hector M. Garcia-Garcia, MD, PhD; Daniel A. Jones, MD, PhD; John K. Khoo, MBBS; Anbukarasi Maran, MD; Koen Nieman, MD; Natalia Pinilla-Echeverri, MD, PhD; Arnold H. Seto, MD, MPA, FSCAI; Evan Shlofmitz, DO; and Emmanouil S. Brilakis, MD, PhD, FSCAI.