Brunetti Natale Daniele, Delli Carri Felice, Ruggiero Maria Assunta, Cuculo Andrea, Ruggiero Antonio, Ziccardi Luigi, De Gennaro Luisa, Di Biase Matteo
Cardiology Department, University of Foggia Foggia Italy.
Interv Med Appl Sci. 2014 Mar;6(1):26-30. doi: 10.1556/IMAS.6.2014.1.4. Epub 2014 Mar 14.
Exact quantification of plaque extension during coronary angioplasty (PCI) usually falls on interventional cardiologist (IC). Quantitative coronary stenosis assessment (QCA) may be possibly committed to the radiology technician (RT), who usually supports cath-lab nurse and IC during PCI. We therefore sought to investigate the reliability of QCA performed by RT in comparison with IC.
Forty-four consecutive patients with acute coronary syndrome underwent PCI; target coronary vessel size beneath target coronary lesion (S) and target coronary lesion length (L) were assessed by the RT, junior IC (JIC), and senior IC (SIC) and then compared. SIC evaluation, which determined the final stent selection for coronary stenting, was considered as a reference benchmark.
RT performance with QCA support in assessing target vessel size and target lesion length was not significantly different from SIC (r = 0.46, p < 0.01; r = 0.64, p < 0.001, respectively) as well as JIC (r = 0.79, r = 0.75, p < 0.001, respectively). JIC performance was significantly better than RT in assessing target vessel size (p < 0.05), while not significant when assessing target lesion length.
RT may reliably assess target lesion by using adequate QCA software in the cath-lab in case of PCI; RT performance does not differ from SIC.
在冠状动脉血管成形术(PCI)期间,对斑块扩展进行精确量化通常由介入心脏病专家(IC)负责。冠状动脉狭窄定量评估(QCA)可能由放射技师(RT)进行,在PCI期间,放射技师通常协助导管室护士和介入心脏病专家。因此,我们试图研究放射技师与介入心脏病专家相比进行QCA的可靠性。
44例连续的急性冠状动脉综合征患者接受了PCI;由放射技师、初级介入心脏病专家(JIC)和高级介入心脏病专家(SIC)评估目标冠状动脉病变下方的目标冠状动脉血管大小(S)和目标冠状动脉病变长度(L),然后进行比较。将确定冠状动脉支架最终选择的SIC评估作为参考基准。
放射技师在QCA支持下评估目标血管大小和目标病变长度的表现与SIC相比无显著差异(r分别为0.46,p<0.01;r为0.64,p<0.001),与JIC相比也无显著差异(r分别为0.79、0.75,p<0.001)。在评估目标血管大小时,JIC的表现明显优于放射技师(p<0.05),而在评估目标病变长度时无显著差异。
在PCI情况下,放射技师在导管室使用适当的QCA软件可可靠地评估目标病变;放射技师的表现与高级介入心脏病专家无异。