Limits of quantitative coronary angiography (QCA) in intermediate stenosis measuring: a correlation and concordance study with intravascular ultrasound (IVUS).

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Published Dec 23, 2014
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Vol. 92 No. 6 (2014): Issue Jun 2014

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H. Ben Ahmed
K. Bouzouita
I. Hamdi
H. Boussaid
A. Mokaddem
Y. Ben Ameur
M. R Boujnah.

Abstract

Background: Although coronarography is still the gold standard to evaluate coronary lesions, it remains a bidimensional representation of a tridimensional complex structure, which can represent a source of error in measurements.

aims: to perform a correlation and concordance study between quantitative coronary angiography (QCA) and intravascular ultrasound measurements for intermediate and ambiguous lesions.

methods: We analysed 40 patients’ coronary arteries from March 2009 to November 2011 by both QCA and intravascular ultrasound to perform then a correlation and concordance study.

results: the correlation study confirmed the limits of the angiogram in providing accurate measurements. The correlation coefficient was yet high in citationsRaw diameters (r=0,78, p<0,001) and minimal lumen diameters (r=0,58, p<0,001), but was middling for stenosis percentages (r=0,23, p=0,03). This coefficient was also high for
lesions lengths (r=0,51, p=0,01).
Bland &Altaman diagrams showed however wide limits of
agreement, reflecting possibility of large measurements error and
confirming the absence of concordance between the two techniques.
Conclusion : Coronarography though being the most widespread
mean of evaluating coronary lesions lacks to provide accurate
measurements, which can influence patient’s management,
especially in case of intermediate lesions.

Keywords:

Coronarography, intravascular ultrasound, quantitative coronary angiography.

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References

  1. Bland JM, Altamn BG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307-10.
  2. Fischer JJ, Samady H, McPherson JA, et al. Comparison between visual assessment and quantitative angiography versus fractional flowreserve for native coronary narrowings of moderate severity. Am JCardiol 2002;90:210-5.
  3. Tobis J, Azarbal B, Slavin L. Assessment of intermediate severitycoronary lesions in the catheterization laboratory. J Am Coll Cardiol2007;49:839-48.
  4. Fernandez MR, Silva GV, Caixeta A et al. Assessing intermediate coronary lesions : angiographic prediction of lesion severity on intravascular ultrasound. J Invasive Cardiol 2007;19:412-16.
  5. Briguori C, Tobis J, Nishida T et al. Descrepancy between angiography and intravascular ultrasound when analyzing small coronay arteries.Eur. Heart J. 2002;23:247-54.
  6. Iwami T, Fujii T, Miura T et al. Limitations of intravascular ultrasound for the evaluation of coronary luminal area, comparison with quantitative angiography. Jpn Circ J 1996;60:575-84.
  7. Dragu R, Kerner A, Gruberg L et al. Angiographically uncertain left main coronary artery narrowings: correlation with multidetector computed tomography and intravascular ultrasound. Int J Cardiovasc Imaging 2008;24:557-63.
  8. Berry C, L'Allier PL, Grégoire J et al. Comparison of intravascular ultrasound and quantitative coronary angiography for the assessment of coronary disease progression. Circulation 2007;115:851-57.
  9. Yamagishi M, Hosokawa H, Saito S et al. Coronary disease morphology and distribution determined by quantitative angiography and intravascular ultrasound. Circulation 2002;60:735-40.