Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery
CPT4 code
Name of the Procedure:
Noninvasive Estimated Coronary Fractional Flow Reserve (FFR) derived from Coronary Computed Tomography Angiography (CTA) using Computational Fluid Dynamics (CFD) Physiologic Simulation Software Analysis
Summary
This noninvasive procedure uses data from a coronary CTA scan and advanced software to simulate blood flow dynamics. It estimates the FFR, a measure of how well blood is flowing through the coronary arteries, to assess the severity of any blockages that may be causing heart problems.
Purpose
The procedure is used to diagnose the severity of coronary artery disease (CAD). The goal is to determine whether a coronary artery blockage is limiting blood flow and needs treatment.
Indications
- Symptoms suggestive of CAD, such as chest pain or shortness of breath.
- Abnormal results from other noninvasive stress tests.
- Patient criteria include those who are at moderate risk for CAD and can undergo a coronary CTA.
Preparation
- Patients may need to fast for 4-6 hours before the CTA scan.
- Medications might need to be adjusted under the guidance of a healthcare provider.
- Preceding tests could include basic blood work and a pre-procedure medical evaluation.
Procedure Description
- Coronary CTA Scan: The patient undergoes a coronary CTA, which involves injecting a contrast dye and taking detailed images of the coronary arteries using a CT scanner.
- Data Analysis: The images are processed using CFD-based software that simulates blood flow and calculates the FFR for different segments of the coronary arteries.
- Reporting: The results are reviewed by a cardiologist, who assesses the FFR values to determine the severity of any blockages.
Tools, Equipment, and Technology
- CT Scanner
- Intravenous contrast dye
- CFD-based physiologic simulation software
Anesthesia/Sedation
- Generally, no anesthesia or sedation is required, although a mild sedative may be used if the patient is anxious.
Duration
The coronary CTA scan itself takes about 10-20 minutes. The data analysis and reporting process might take a few hours to a day depending on the facility's workflow.
Setting
Primarily performed in a hospital's radiology or cardiology department.
Personnel
- Radiologists and radiologic technologists handle the CTA scan.
- Cardiologists and specialized software analysts conduct the FFR calculations.
- Nurses and other support staff assist as needed.
Risks and Complications
- Exposure to radiation from the CT scan.
- Allergic reaction to the contrast dye.
- Rarely, patients may experience discomfort or anxiety.
Benefits
- Noninvasive and less risky than traditional invasive FFR measurement.
- Provides valuable information regarding coronary artery blockages without the need for catheterization.
- Results can guide further treatment decisions, potentially avoiding unnecessary procedures.
Recovery
- Generally, no significant recovery time; patients can resume normal activities almost immediately.
- Any specific post-procedure instructions will be provided by the healthcare provider.
Alternatives
- Invasive coronary angiography with direct FFR measurement.
- Other noninvasive tests such as stress echocardiography or nuclear stress testing.
- Pros of this noninvasive FFR: Safer, less discomfort, no need for catheterization. Cons: Less precise than direct FFR measurement.
Patient Experience
- During the CTA scan, the patient might feel a warm sensation from the contrast dye injection.
- Some patients may experience mild anxiety inside the CT scanner.
- Post-scan, most patients feel normal and can quickly return to their daily activities.
- Pain management is typically not necessary due to the noninvasive nature of the procedure.