Coronary computed tomography angiography to guide percutaneous coronary intervention: Expert opinion from a SCAI/SCCT roundtable

J Cardiovasc Comput Tomogr. 2025 May-Jun;19(3):277-290. doi: 10.1016/j.jcct.2025.04.015. Epub 2025 May 12.

Abstract

Coronary computed tomography angiography (CCTA) has emerged as an important tool for planning percutaneous coronary intervention (PCI). While it has traditionally been employed for diagnostic purposes, increasing evidence and real-world experience suggest that CCTA can be used for the pre-procedural planning of PCI and inform patient triage, shared decision-making, case complexity, and resource use. This approach mirrors how computed tomography angiography is routinely used to plan structural interventions. To address these emerging opportunities, the Society for Cardiovascular Angiography & Interventions (SCAI) and the Society of Cardiovascular Computed Tomography (SCCT) organized a multidisciplinary, expert scientific roundtable on the use of CCTA for guiding PCI. The goal of this document is to provide a state-of-the-art overview of CCTA-guided PCI, focused on practical applications and key coronary lesion subsets, define unmet needs and barriers, and outline future directions.

Keywords: Coronary artery disease; Coronary computed tomography angiography; Percutaneous coronary intervention.

Publication types

  • Review
  • Practice Guideline

MeSH terms

  • Clinical Decision-Making
  • Computed Tomography Angiography* / adverse effects
  • Computed Tomography Angiography* / standards
  • Consensus
  • Coronary Angiography* / adverse effects
  • Coronary Angiography* / methods
  • Coronary Angiography* / standards
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / therapy
  • Coronary Vessels* / diagnostic imaging
  • Humans
  • Patient Selection
  • Percutaneous Coronary Intervention* / adverse effects
  • Predictive Value of Tests
  • Treatment Outcome