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

Yader Sandoval; Jonathon Leipsic; Carlos Collet; Ziad A Ali; Lorenzo Azzalini; Emanuele Barbato; João L Cavalcante; Ricardo A Costa; Hector M Garcia-Garcia; Daniel A Jones; John K Khoo; Anbukarasi Maran; Koen Nieman; Natalia Pinilla-Echeverri; Arnold H Seto; Evan Shlofmitz; Emmanouil S Brilakis

doi:10.1016/j.jcct.2025.04.015

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.

Authors

Yader Sandoval¹, Jonathon Leipsic², Carlos Collet³, Ziad A Ali⁴, Lorenzo Azzalini⁵, Emanuele Barbato⁶, João L Cavalcante⁷, Ricardo A Costa⁸, Hector M Garcia-Garcia⁹, Daniel A Jones¹⁰, John K Khoo¹¹, Anbukarasi Maran¹², Koen Nieman¹³, Natalia Pinilla-Echeverri¹⁴, Arnold H Seto¹⁵, Evan Shlofmitz¹⁶, Emmanouil S Brilakis¹⁷

Affiliations

¹ Allina Health Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA; Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, MN, USA. Electronic address: yadersandoval@gmail.com.
² Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada; Department of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
³ Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
⁴ Department of Cardiology, St. Francis Hospital, Roslyn, NY, USA; New York Institute of Technology, Old Westbury, NY, USA.
⁵ Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA.
⁶ Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy; Cardiology Unit, Sant'Andrea University Hospital, Rome, Italy.
⁷ Allina Health Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA; Cardiovascular Imaging Core Lab and Research Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, USA.
⁸ Department of Invasive Cardiology, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
⁹ Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
¹⁰ Centre for Cardiovascular Medicine and Devices, Queen Mary University of London, London, UK.
¹¹ Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
¹² Division of Cardiology, Medical University of South Carolina, Charleston, SC, USA.
¹³ Stanford University School of Medicine and Cardiovascular Institute, Stanford, CA, USA.
¹⁴ McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada.
¹⁵ Long Beach VA Health Care System, Long Beach, CA, USA.
¹⁶ Department of Cardiology, St. Francis Hospital, Roslyn, NY, USA.
¹⁷ Allina Health Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA; Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, MN, USA.

PMID: 40360362
DOI: 10.1016/j.jcct.2025.04.015

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