3D EBA showing bypass grafts
FDA approved alternative to conventional coronary angiography
Approved by the FDA in November 1999, non-invasive coronary angiography (EBA) done on the GE-Imatron Electron Beam CT scanner provides the opportunity to examine the coronary arteries without the risks associated with conventional angiography. In addition, the EBA also provides valuable additional myocardial information including myocardial mass, wall motion, wall thickness and ejection fraction. Coronary angiography done with the GE-Imatron Electron Beam CT Scanner is an outpatient procedure that requires only about one half hour of the patient's time and is reimbursed by insurance plans
Statistics: In excess of one million coronary angiograms are performed in the United States each year. About 30 percent of these procedures will reveal no abnormality or an abnormality that does not require intervention. The cost of a cardiac catheterization ranges from $3000 to $6000, and requires a short hospital stay (6-8 hours). Mortality and morbidity for this procedure is 0.15% and 1.5%, respectively. This means that hundreds of thousands of Americans each year are unnecessarily put to the expense, discomfort and risk of conventional coronary angiography.
EBA vs. Conventional Coronary Angiography
Numerous studies published in the peer reviewed medical journals over the past several years have demonstrated that electron beam CT coronary angiography (EBA) is an acceptable alternative to cardiac catheterization in many clinical situations. EBA can successfully image the coronary arteries in 93% of patients with more than 80% of the coronary artery segments being analyzable. The location distribution of the 20% of the coronary artery segments that are unanalyzable is 8% proximal, 22% middle and 70% distal. EBA has an 80-85% sensitivity and 90-95% specificity for detecting significant coronary stenosis in the proximal 2/3 of the coronary vasculature.
The accuracy for detecting coronary stenosis is highest in the left main artery and left anterior descending artery and lowest in the circumflex artery. The sensitivity and specificity detecting patency of coronary bypass grafts using EBA is 95-100% and 89-100% respectively. EBA can also be very helpful detecting restenosis in patients with recurrent chest pain within the restenosis window after percutaneous coronary interventions and in localizing the coronary sinus in advance of cardiac pacemaker placement.
Angiography of other Vascular Systems:
In addition to the coronary vasculature, the Electron Beam CT scanner is capable of performing high quality 3D angiograms of the peripheral arterial system including the aorta (for aneurysm or dissection), the carotid arteries, the pulmonary arteries and the renal arteries.
Who Should be Considered for this Test?
All individuals being considered for conventional coronary angiography as a result of either symptoms (chest pain or angina) or positive or inconclusive exercise (treadmill) testing.
Individuals who have had bypass surgery, angioplasty or atherectomy, and need a re-evaluation of the condition of the revascularization(s) (bypass graft or stent patency).
Individuals who have had bypass surgery, angioplasty or atherectomy, and are experiencing new symptoms (chest pain, shortness of breath, fatigue, etc.).
All Individuals with an unexplained cardiomyopathy
For localization of the coronary sinus prior to pacemaker placement.
Other indicators: Evaluation of Congenital Heart Disease, annual follow-up of patients after heart transplant, Coronary vein assessment, pacemaker placement.