Purpose. Determine the possibilities of using the SYNTAX scale based on the data of 640-slice CT-coronarography and CAD-RADS rating system for coronary artery revascularization.

Materials and methods. The study included 14 people (12 men, 2 women) from 44 to 79 years (M=60.5±8.7 yr), who have coronary artery stenting only on the basis of MSCT-coronarography and positive stress testing. All patients performed MSCT-coronarography on the Aquilion ONE-640 with intravenous contrast (Iopromide 370 mg/ml or Iogexol 350 mg/ml) according to the standard protocol. In addition, the results of determining the method of myocardial revascularization based on the Syntax scale from the data of 640-slice CT-coronarography and invasive coronarography (during stenting) were studied.

Results. In 14 cases, coronary artery changes in MSCT-coronarography were in the categories CAD-RADS 4A, B and CAD-RADS 5. According to MSCT-coronarography, 14 patients had stenotic lesions of 18 arteries, in coronarography in one patient stenosis was 50%. A total of 13 patients were implanted with 21 stents. Nine stents (42.9%) were placed in the right coronary artery, 12 (57.1%) in the left descending and circumflex arteries. On the Syntax scale, the severity of coronary arteries stenosis was assessed based on MSCT-coronarography and invasive coronarography data to select treatment tactics. According to the tomography, the score of the lesion ranged from 2.0 to 14.5 (M=5.7±3.3), based on traditional coronarography, it was between 0 and 16.5 (M=5.2±3.1) (p<0.05).

Conclusion. The 640-slice CT-coronarography is a reliable alternative to invasive coronarography and can be a method of selecting treatment tactics based on the Syntax scale and CAD-RADS system.