Overview
Transection of a coronary artery is a rare but potentially life-threatening complication that can occur during percutaneous coronary intervention (PCI) or other cardiac procedures. It involves a complete or partial tear through the wall of a coronary artery.Diagnosis
Coronary computed tomography angiography (CCTA) can provide detailed anatomical and morphological information of coronary arteries, including plaque characteristics and suitability for intervention 1.
CCTA can aid in identifying coronary sites suitable for surgical anastomosis 1.Management
CCTA can assist in preprocedural planning and periprocedural guidance in complex coronary artery disease (CAD), including bifurcations and calcified lesions 1.
CCTA-derived fractional flow reserve (FFR) and CT myocardial perfusion imaging can improve referrals for coronary revascularization and guide the preferred mode of intervention 1.
CCTA can inform stent size selection based on plaque analysis and physiological information 1.Key Recommendations
Coronary computed tomography angiography (CCTA) is a guideline-recommended imaging modality for detecting coronary artery stenoses and risk stratification in patients with low-to-intermediate pretest likelihood of CAD 1. (Evidence: Strong)
CCTA provides additive value over invasive angiography for detailed plaque evaluation, improved referrals for revascularization, preprocedural planning and periprocedural guidance in complex CAD, stent size selection, and identification of sites for surgical anastomosis 1. (Evidence: Moderate)
CCTA-derived fractional flow reserve and/or CT myocardial perfusion imaging can improve referrals to coronary revascularization and guide the preferred mode of intervention 1. (Evidence: Moderate)References
1 Opolski MP, Kruk M, Kępka C, Wolny R, Milewski K, Kachel M et al.. Cardiac computed tomography for planning and guidance of coronary revascularization: An expert position of the Association of Cardiovascular Interventions of the Polish Cardiac Society. Kardiologia polska 2025. link