Document Detail


Lesion characteristics and coronary stent selection with computed tomographic coronary angiography: a pilot investigation comparing CTA, QCA and IVUS.
MedLine Citation:
PMID:  20603505     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The accurate assessment of a target coronary lesion and appropriate stent selection is important in ensuring procedural success during percutaneous coronary intervention (PCI). Though quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) are available, stent selection is most commonly performed by visual estimation alone. Computed tomographic coronary angiography (CTA) has been shown to correlate well with QCA and IVUS in the assessment of coronary stenoses and may also have a role in stent guidance.
MATERIALS AND METHODS: Patients awaiting elective PCI underwent CTA. Blinded observers assessed lesion characteristics using: CTA, QCA, IVUS and visual estimation. Luminal diameters, lesion lengths, ACC/AHA lesion types and CTA-suggested stent sizes were compared.
RESULTS: A total of 17 patients (26 lesions) were evaluated. There was good correlation between CTA and IVUS for luminal diameter and for lesion length (r = 0.86 and 0.71, respectively). Similarly, the inter-test variability between the two methods using the intra-class coefficient (ICC = 0.85) was similar to the inter-observer variability of IVUS (ICC = 0.90). The agreement between CTA and visual estimation for lesion type was good (K = 0.79) and was similar to the agreement between the two visual observers (K = 0.72). There was good correlation between CTA stent recommended and actual stent selected (diameter, r = 0.82; length, r = 0.64).
CONCLUSIONS: If CTA data is available prior to coronary angioplasty, the reporting of luminal size, length, and lesion type may assist the clinician with coronary stent selection.
Authors:
Malek Kass; Christopher A Glover; Marino Labinaz; Derek Y F So; Li Chen; Yeung Yam; Benjamin J W Chow
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-06     Completed Date:  2010-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  328-34     Citation Subset:  IM    
Affiliation:
Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada K1Y 4W7.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / methods*
Coronary Angiography*
Coronary Disease / radiography*,  therapy,  ultrasonography*
Female
Humans
Male
Middle Aged
Observer Variation
Pilot Projects
Prospective Studies
Stents*
Tomography, X-Ray Computed*
Ultrasonography, Interventional*
Grant Support
ID/Acronym/Agency:
MSH-83718//Canadian Institutes of Health Research
Comments/Corrections
Comment In:
J Invasive Cardiol. 2010 Jul;22(7):335   [PMID:  20603506 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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