CORRESPONDENCE: LETTER TO THE EDITOR
Reply
Pim J. de Feyter, MD, PhD*
* Thoraxcenter, Erasmus Medical Center, Cardiology and Radiology, Hs207, P.O. Box 2040, Rotterdam, Zuid Holland 3000 CA, the Netherlands (Email: p.j.defeyter{at}erasmusmc.nl).
As a practicing coronary angiographer and interventionalist for many years, I appreciate, respect, and agree with the comments of Dr. Conti regarding our recent paper (1). The virtues of catheter-based coronary angiography, so well presented in his letter to the editor, are many, and the majority of the opportunities of invasive coronary angiography cannot be replaced by a noninvasive imaging technique such as computed tomography (CT) coronary angiography. But I do not entirely agree with the notion that CT coronary angiography will become a useful but "limited" imaging device for coronary assessment. At the current stage of CT technology, it definitely falls short of invasive coronary angiography, but new detector technology has improved the spatial resolution to reduce the gap between the diagnostic accuracy of invasive coronary angiography and CT coronary angiography. Obviously, the dynamic nature of Thrombolysis In Myocardial Infarction flow grade, myocardial blush, and assessment of collaterals, as well as pressure measurements will remain in the domain of invasive coronary angiography, whereas invasive coronary angiography is an indispensable roadmap for intracoronary diagnostic devices and invasive catheter-based coronary obstruction treatment.
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References
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1. Meijboom WB, Meijs MFL, Schuijf JD, et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study J Am Coll Cardiol 2008;52:2135-2144.[Abstract/Free Full Text]
Related Article
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Coronary Angiography: Catheter Based or Computed Tomography Based
- C. Richard Conti
J. Am. Coll. Cardiol. 2009 53: 2405-2406.
[Full Text]
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