Diagnostic Methods in the Cardiac Catheterization Laboratory PDF

Preface

Coronary angiography has revolutionized the diagnostic approach to patients with coronary artery disease and plays a central role in modern, pharmacological, transcatheter, and surgical treatment approaches. It has transformed the field of cardiology and defined the subspecialty of interventional cardiology.

However, despite the increasing understanding of the atherosclerotic disease process and advanced diagnostic and therapeutic options, coronary artery disease remains a major cause of morbidity and mortality worldwide. These facts demonstrate the need for additional anatomic and physiologic assessment of coronary disease beyond angiographic luminal stenosis, which has led to the development of several secondary transcatheter diagnostic modalities.

In modern catheterization laboratories worldwide, diagnostic evaluation of coronary artery disease has evolved far beyond angiography alone, allowing not only anatomic assessment of the artery lumen/stenosis but also of the wall/plaque, and physiologic assessment of hemodynamic lesion significance. In addition, more recent developments of noninvasive modalities, and in particular cardiac computed tomography and magnetic resonance imaging, allow complementary assessment with the future prospect of hybrid laboratories. Such comprehensive diagnostic evaluation of coronary lesions is the basis for advances in transcatheter interventions.

This expanding focus of coronary multimodality imaging in modern catheterization laboratories requires knowledge of several diagnostic modalities. In this title an international group of authors and editors including cardiologists and radiologists have collected comprehensive state-of-the-art information about the evolving diagnostic approach in the catheterization laboratory. The use of qualitative and quantitative angiography of the coronary arteries, great vessels, and peripheral arteries is discussed in the context of routine and challenging clinical scenarios (chronic total occlusion, bifurcation lesions, plaque vulnerability). Additional chapters discuss further catheter-based anatomic evaluation with intravascular ultrasound and optical coherence tomography, and assessment of lesions significance with fractional flow reserve and intracoronary Doppler. The emerging role of complementary noninvasive imaging with cardiac computed tomography and magnetic resonance imaging is the topic of dedicated chapters. The chapters describe diagnostic assessment and therapeutic consequences.

This title provides a comprehensive guide to the diagnostic approach in modern catheterization laboratories and its impact on interventional transcatheter treatment strategies. Directed toward cardiologists and radiologists performing diagnostic and interventional procedures in the catheterization laboratory, this title gives an up-to-date perspective but also a look into the future.