Gm. Stiel et al., ON-SITE DIGITAL QUANTITATIVE CORONARY ANGIOGRAPHY - COMPARISON WITH VISUAL READINGS IN INTERVENTIONAL PROCEDURES, International journal of cardiac imaging, 12(4), 1996, pp. 263-269
Citations number
29
Categorie Soggetti
Cardiac & Cardiovascular System","Radiology,Nuclear Medicine & Medical Imaging
In order to review the morphological criterion for an interventional p
rocedure, diameter stenosis (%DS) of 226 coronary lesions in 200 patie
nts undergoing elective coronary angiography with an option for 'prima
vista' angioplasty (pPTCA), was assessed on-site by both visual 'eye
balling' (EB) and independent digital quantitative coronary angiograph
y (DQCA) by means of an angiographic workstation. Compared to DQCA, EB
overestimated the %DS between 50 and 80% and accounted for the majori
ty of discrepancies with overestimation up to 45%. Concordant estimate
s of %DS by both methods were observed in only 10 of the total of 226
stenotic segments; in 20 of 226 cases, EB underestimated %DS up to 20%
. EB revealed a %DS greater than or equal to 60% in 166 stenoses (73.4
%), an estimate that led to subsequent pPTCA. However, only 119 (52.6%
) of these lesions had a %DS greater than or equal to 60% as assessed
objectively by DQCA. With regard to the criterion for PTCA 47 of 166 p
erformed pPTCA (28.3%) would not meet the indication criteria based on
objective DQCA information. EB and DQCA (+/- 5%DS) had concordant res
ults and criteria for pPTCA only in 103 of 166 coronary lesions (62.1%
). These results lead to the conclusion that, on-site and on-line DQCA
by an independent cardiologist eliminates both under- and overestimat
ion of stenoses as seen with EB. DQCA supports immediate decision-maki
ng and appears necessary for reliable evaluation of coronary morpholog
y in an interventional catheterization laboratory setting and may even
tually ensure intraprocedural quality control.