Screening CT-coronary angiography: ready for prime time?

Computed tomographic coronary angiography (CTCA) can assist with the diagnosis of a variety of cardiovascular disorders. The rationale for performing screening CTCA is to define the presence, absence, and severity of coronary artery disease, particularly in those patients who are categorized to be at intermediate risk by conventional risk factor assessment for a cardiovascular event. In addition to coronary artery disease, the interventional cardiologist can also use CTCA to evaluate the presence of an anomalous origin of the coronary arteries, the size of the coronary arteries for potential stent placement, the extent of coronary calcium in the obstructive segment and bypass graft patency. With conventional coronary angiography, the combined radiogenic and non-radiogenic mortality is 0.13%, compared to 0.07% with CTCA. Radiation to the clinician is also greatly reduced.