We agree with Becker et al1 that the outcome of coronary artery dissection was the result of overuse of diagnostic imaging. However, it was not the result of the CCTA examination but rather the response to that result that likely was in error. Unnecessary invasive coronary angiography (ICA) examinations are performed routinely in patients. A recent publication showed that no CAD was found in 39.6% of patients and obstructive CAD was found in only 37.6% of patients.2 In many patients, ICA can result in added unnecessary cost and a small but significant morbidity and mortality.
Stillman AE, Woodard PK, RESCUE Investigators. Consequence of Overuse of Invasive Coronary Angiography. Arch Intern Med. 2011;171(7):702–710. doi:10.1001/archinternmed.2011.112
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