CCTA is recommended as a first-line non-invasive anatomical test and CT-FFR as a functional assessment.
Key Messages
The 2024 ESC Guidelines for Chronic Coronary Syndromes highlight the key roles of coronary computed tomography angiography (CCTA) and computed tomography fractional flow reserve (CT-FFR) in diagnosing and managing coronary artery disease (CAD):
- CCTA is recommended as the first-line non-invasive anatomical test to rule out obstructive CAD and to detect nonobstructive CAD. It is particularly useful in patients with a low to moderate pre-test likelihood of disease, providing detailed images of the coronary arteries.
- CT-FFR, which calculates the fractional flow reserve using CCTA images, offers a functional assessment of coronary stenosis without the need for invasive testing. This helps correlate myocardial ischemia with anatomical findings, improving the diagnostic accuracy and guiding decisions on coronary revascularization.
Both tools significantly reduce the need for invasive coronary angiography (ICA) in certain patient populations and improve patient selection for further diagnostic procedures, enhancing overall management strategies for CCS.
2024 Essential Messages from ESC Guidelines
The 2024 ESC Clinical Practice Guidelines for the Management of Chronic Coronary Syndromes (CCS) introduce important updates, emphasizing a shift toward a more comprehensive understanding of coronary artery disease (CAD). A significant role is assigned to coronary computed tomography angiography (CCTA) as a first-line imaging test for diagnosing obstructive CAD, particularly in patients with low or moderate pre-test likelihood. This test, combined with its functional counterpart, CT fractional flow reserve (CT-FFR), provides a non-invasive assessment of coronary blood flow and is crucial for determining the functional significance of coronary lesions.
Professors Christiaan Vrints and Felicita Andreotti, who co-chaired the guidelines task force, explained that CCTA helps clinicians evaluate the physiological impact of coronary stenosis, offering more precise decision-making in the management of CAD. This combination of anatomical and functional imaging allows for a detailed understanding of both obstructive and non-obstructive coronary conditions, minimizing unnecessary invasive procedures.
Furthermore, in patients with a higher pre-test likelihood of CAD, stress imaging modalities like echocardiography or PET are recommended before considering invasive coronary angiography (ICA). The guidelines also introduce a structured, stepwise approach to managing CCS, from initial risk assessment to personalized treatment strategies, which include lifestyle changes, medical therapy, and revascularization where appropriate.
These updates solidify the pivotal role of CCTA and CT-FFR in modern cardiac care, enabling accurate diagnosis and guiding therapy in line with the latest understanding of coronary syndromes.
Links to ESC and ACC publications:
About DEEPVESSEL FFR
DEEPVESSEL FFR is a software medical device that uses deep learning technology to perform a non-invasive physiological functional assessment of the coronary arteries using coronary computed tomography angiography (CCTA). The software processes coronary CTA images semi-automatically, generates a three-dimensional model of the coronary artery tree, and estimates CT FFR values. DEEPVESSEL FFR is FDA-Cleared, CE-Marked, NMPA-Cleared, HSA-Certified.
About Keya Medical
Keya Medical is an international medical technology company developing deep learning-based medical devices for disease diagnosis and treatment. The company is committed to creating solutions that deliver clinical value at all stages in the patient care process, covering specialties including cardiology, neurology, pulmonology, pathology, and surgery. Keya Medical has four centers of excellence in Beijing, Shanghai, Shenzhen, and Seattle. Follow us on LinkedIn, Twitter, and Facebook.
Media Contact
contact@keyamedna.com
Learn more about DEEPVESSEL FFR
We are actively looking for clinical partners in the United States and EMEA.