IN-VITRO VALIDATION OF INTRAVASCULAR ULTRASOUND IMAGING AFTER BALLOONANGIOPLASTY OF CORONARY-ARTERY STENOSES

Systematic studies of intravascular ultrasound imaging of in vitro bal loon angioplasty on coronary arteries with a greater than 50% diameter stenosis on angiogram have not been performed, We used 23 plasma-perf used postmortem human coronary arteries with an angiographic diameter stenosis of greater than or equal to 50%. After balloon dilation the v essels were examined by 30-MHz intravascular ultrasound imaging (IVUS) and the presence of ruptures and dissections was noted, Ruptures were defined as disruptions of the vessel wall in a radial direction, and dissections were defined as disruptions in a circumferential direction , After pressure fixation they were studied by histology, On IVUS, 24 vessel wall disruptions were diagnosed in 14 arteries, On histology, 2 9 disruptions were diagnosed in 19 arteries, The sensitivity of IVUS f or the detection of disruptions was 79%, the specificity was 75%, Tota l agreement was 79%. Accuracy was better for dissections (total agreem ent 96%) than for ruptures (total agreement 74%), Shadowing behind cal cium and close contact of the catheter to the arterial wall were impor tant sources of error in the IVUS analysis, We conclude that intravasc ular ultrasound imaging is accurate for the detection of disruptions a fter balloon angioplasty of angiographically significant coronary arte ry stenoses. Copyright (C) 1996 World Federation for Ultrasound in Med icine & Biology