EuroPCR 2018 | SYNTAX III REVOLUTION: Excellent Correlation Between Angiography and Computerized Tomography in Patients with Left Main and Multivessel Disease

In patients with left main or three-vessel coronary disease, heart team decisions on revascularization strategy (angioplasty or surgery) may be made based solely on noninvasive computerized tomography (CT) angiography, since there is great correlation between its results and those determined by conventional angiography.

SYNTAX III REVOLUTION: Muy buena correlación entre angiografía y tomografía en pacientes con tronco y múltiples vasos.For the SYNTAX III REVOLUTION study, Dr. Serruys and his colleagues randomized 6 heart teams from 5 different countries to review imaging from 223 patients with left main or three-vessel disease. Three of these teams only had access to fractional flow reserve (FFR) derived from CT (FFRCT; HeartFlow), while the other three only had access to conventional angiography. All teams included clinical cardiologists, interventional cardiologists, surgeons, and radiologists. Furthermore, all physicians ultimately had access to all available information before the final verdict.


Read also: Routine FFR/iFR Reclassifies Treatment Strategies in Half of Cases.


All randomized teams agreed with their treatment decisions in 92.8% of patients, while the FFRCT/HeartFlow teams changed their mind in only 7% of patients after access to conventional angiography. In most cases, such treatment change was from surgery to angioplasty.

 

The novelty here was the addition of radiologists to the heart team, since surgeons are used to discussing angiography with interventional cardiologists. In consequence, during this trial, surgeons discovered two things: the coronary CT angiography and the FFR derived from CT.


Read also: EuroPCR 2018 | SCAAR Registry at 10 years: FFR improves decision making in the long term.


Ultimately, will surgeons feel comfortable bringing to the OR patients who have not undergone conventional angiography? Only time will answer that question.

 

Original title: Coronary Computed Tomography Angiography for Heart Team Decision-Making in Multivessel Coronary Artery Disease: The SYNTAX III REVOLUTION Trial.

Reference: Serruys PW et al. EuroPCR 2018. May 22, 2018. Paris, France.

 

Syntax-3-Revolution-presentacion


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

Evolution of Small Balloon-Expandable Valves

Small aortic rings (20 mm) have posed a significant challenge for both surgery and transcatheter aortic valve implantation (TAVI) due to their association with an...

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 – ECLIPSE: Randomized Study of Orbital Atherectomy vs Conventional PCI in Severely Calcified Lesions

Coronary calcification is associated with stent under-expansion and increased risk of both early and late adverse events. Atherectomy is an essential tool for uncrossable...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....