SCAI 2026 Bifurcation PCI Reimagined: Data-Driven Decisions in Complex Anatomy-CT-Guided Bifurcation PCI, Dr. Sandoval

Video Transcription

Video Summary

The speaker argues that coronary CT should be used before PCI, especially for bifurcation lesions, because these cases are common and complex. Despite strong guideline support for wire guidance and intravascular imaging, these tools are still underused. CT-guided PCI is defined as an interventional cardiologist directly reviewing CT images to plan the procedure, not just reading a report. CT can help assess vessel size, calcium, plaque distribution, fluoroscopic angles, side-branch importance, and myocardial mass at risk. It can also support virtual PCI and predict outcomes like side-branch occlusion or post-stent FFR. New software and photon-count CT scanners are making this more practical and accurate. The discussion also highlighted workflow, training, and reimbursement concerns, with a push for cardiologists to take a larger role in CT interpretation and planning.

Asset Caption

closed captions are computer-generated

Keywords

coronary CT

PCI planning

bifurcation lesions

intravascular imaging

CT-guided PCI

side-branch occlusion