Comparison between three-dimensional angiographic reconstruction and intravascular ultrasound imaging for the measurement of cross-sectional luminal dimensions in intermediate coronary lesions.

BACKGROUND

Intravascular ultrasound (IVUS) has enabled the measurement of minimal luminal area of coronary stenoses. We evaluated the hypothesis that angiographic three-dimensional reconstruction of luminal dimensions may be able to provide similar measurements to IVUS in intermediate coronary lesions.

METHODS

We retrospectively enrolled patients undergoing invasive coronary angiography and IVUS for the assessment of angiographically intermediate coronary lesions (50-70%) at a high-volume tertiary care hospital between July 1, 2006, and May 20, 2008. IVUS (Boston Scientific, Natick Massachusetts, USA) minimal cross-sectional area (CSA) and minimal luminal diameters (MLD) were compared with the measurements obtained using a sophisticated three-dimensional angiographic reconstruction software (CardiOP-B, Paieon, Inc., Rosh Ha'ayin, Israel), with orthogonal angiographic views used to reconstruct and calculate lesion dimensions.

RESULTS

Data were obtained from 34 patients with 35 lesions. The lesions were assessed in the left main (n = 2), left anterior descending artery (n = 15), left circumflex/marginal artery (n = 7), and right coronary artery (n = 11). Using IVUS, the mean minimal CSA was 3.78 +/- 1.60 mm(2), and MLD was 1.88 +/- 0.43 mm. Three-dimensional reconstruction measurements of minimal CSA (3.42 +/- 1.66 mm(2)) highly correlated in a linear fashion with the measurements by IVUS (R = 0.88, P < 0.0001).

CONCLUSIONS

A three-dimensional angiographic measurement of coronary minimal CSA is highly correlated with the measurements using IVUS. This new software technology may be a promising imaging modality to measure CSAs in coronary lesions.