TY - JOUR
T1 - Discrepancies in vessel sizing between angiography and intravascular ultrasound varies according to the vessel evaluated
AU - Takagi, Kensuke
AU - Shannon, Joanne
AU - Basavarajaiah, Sandeep
AU - Latib, Azeem
AU - Al-Lamee, Rasha
AU - Hasegawa, Tasuku
AU - Godino, Cosmo
AU - Ferraro, Massimo
AU - Figini, Filippo
AU - Carlino, Mauro
AU - Montorfano, Matteo
AU - Chieffo, Alaide
AU - Colombo, Antonio
PY - 2013/10/9
Y1 - 2013/10/9
N2 - Background/objectives Quantitative coronary analysis (QCA) of the coronary artery and stent size may be influenced by anatomical location in relation to both calibration point and the X-ray tube. The impact of this phenomenon on lesion assessment is undetermined. Methods In total, 427 consecutive patients who underwent PCI with intravascular ultrasound (IVUS)-guidance were enrolled. The minimum stent diameter (MSD) was measured using QCA (MSDQCA) and IVUS (MSDIVUS) analysis. We used reference objects positioned at a different height from the X-ray source to validate our approach. Results A statistically positive moderate correlation was observed between MSD QCA and MSDIVUS (r = 0.649, p = 0.001). The mean MSD QCA and MSDIVUS were 3.04 ± 0.49 mm and 2.68 ± 0.47 mm respectively. The difference between MSDQCA and MSDIVUS of > 0.75 mm was more frequently observed in the LCx rather than in the LAD (7.4% in the LAD vs. 24.3% in the LCx, p = 0.001). The discrepancy between the MSDQCA and MSDIVUS for the LCx was larger than for the LAD, and tended to be larger than for the RCA (13.3% vs. 18.5%, p = 0.05 and 18.5% vs. 14.5%, p = 0.17). A discrepancy > 20% was more frequently observed in the small (≤ 2.5 mm) than in the large MSD IVUS group (52.7% vs. 25.1%, p = 0.001). This discrepancy was more common in the LCx than in the LAD or RCA (48.6% vs. 30.9% vs. 31.2%, p = 0.03). Conclusions Assessment of the MSDQCA is more likely to overestimate in the LCx than in the LAD, particularly when the MSDIVUS is < 2.5 mm. Therefore, we should be less aggressive in oversizing balloons and stents based on QCA for the LCx or small vessel intervention.
AB - Background/objectives Quantitative coronary analysis (QCA) of the coronary artery and stent size may be influenced by anatomical location in relation to both calibration point and the X-ray tube. The impact of this phenomenon on lesion assessment is undetermined. Methods In total, 427 consecutive patients who underwent PCI with intravascular ultrasound (IVUS)-guidance were enrolled. The minimum stent diameter (MSD) was measured using QCA (MSDQCA) and IVUS (MSDIVUS) analysis. We used reference objects positioned at a different height from the X-ray source to validate our approach. Results A statistically positive moderate correlation was observed between MSD QCA and MSDIVUS (r = 0.649, p = 0.001). The mean MSD QCA and MSDIVUS were 3.04 ± 0.49 mm and 2.68 ± 0.47 mm respectively. The difference between MSDQCA and MSDIVUS of > 0.75 mm was more frequently observed in the LCx rather than in the LAD (7.4% in the LAD vs. 24.3% in the LCx, p = 0.001). The discrepancy between the MSDQCA and MSDIVUS for the LCx was larger than for the LAD, and tended to be larger than for the RCA (13.3% vs. 18.5%, p = 0.05 and 18.5% vs. 14.5%, p = 0.17). A discrepancy > 20% was more frequently observed in the small (≤ 2.5 mm) than in the large MSD IVUS group (52.7% vs. 25.1%, p = 0.001). This discrepancy was more common in the LCx than in the LAD or RCA (48.6% vs. 30.9% vs. 31.2%, p = 0.03). Conclusions Assessment of the MSDQCA is more likely to overestimate in the LCx than in the LAD, particularly when the MSDIVUS is < 2.5 mm. Therefore, we should be less aggressive in oversizing balloons and stents based on QCA for the LCx or small vessel intervention.
KW - Angiography
KW - Discrepancy
KW - Intravascular imaging
KW - Lesion location
KW - MSD
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U2 - 10.1016/j.ijcard.2013.06.004
DO - 10.1016/j.ijcard.2013.06.004
M3 - Article
C2 - 23856443
AN - SCOPUS:84886285214
SN - 0167-5273
VL - 168
SP - 3791
EP - 3796
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 4
ER -