Document Detail

On-site digital quantitative coronary angiography: comparison with visual readings in interventional procedures. Implications for decision and quality control.
MedLine Citation:
PMID:  8993989     Owner:  NLM     Status:  MEDLINE    
In order to review the morphological criterion for an interventional procedure, diameter stenosis (%DS) of 226 coronary lesions in 200 patients 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 angiography (DQCA) by means of an angiographic workstation. Compared to DQCA, EB overestimated the %DS between 50 and 80% and accounted for the majority of discrepancies with overestimation up to 45%. Concordant estimates 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 > or = 60% in 166 stenoses (73.4%), an estimate that led to subsequent pPTCA. However, only 119 (52.6%) of these lesions had a %DS > or = 60% as assessed objectively by DQCA. With regard to the criterion for PTCA 47 of 166 performed pPTCA (28.3%) would not meet the indication criteria based on objective DQCA information. EB and DQCA (+/-5%DS) had concordant results 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 overestimation of stenoses as seen with EB. DQCA supports immediate decision-making and appears necessary for reliable evaluation of coronary morphology in an interventional catheterization laboratory setting and may eventually ensure intraprocedural quality control.
G M Stiel; K P Schaps; A Lattermann; C A Nienaber
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of cardiac imaging     Volume:  12     ISSN:  0167-9899     ISO Abbreviation:  Int J Card Imaging     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-03-26     Completed Date:  1997-03-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8600426     Medline TA:  Int J Card Imaging     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  263-9     Citation Subset:  IM    
Department of Cardiology, University Hospital Eppendorf, Hamburg, Germany.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Angiography*
Coronary Disease / radiography,  therapy
Middle Aged
Radiographic Image Enhancement
Radiographic Image Interpretation, Computer-Assisted*

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