Angiographically uncertain left main coronary artery narrowings: correlation with multidetector computed tomography and intravascular ultrasound

Dragu, Robert; Kerner, Arthur; Gruberg, Luis; Rispler, Shmuel; Lessick, Jonathan; Ghersin, Eduard; Litmanovich, Diana; Engel, Ahuva; Roguin, Ariel

doi:10.1007/s10554-007-9290-0

Cited by 24 publications

(9 citation statements)

References 28 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These observations are not substantially different from those of a meta-analysis that included 16-and 64-slice MDCT systems [9]. In some studies with native coronary arteries, 16-and 64-slice MDCT systems have been shown to have a good correlation with conventional coronary angiography and IVUS for parameters such as minimum lumen diameter, minimum lumen area, and area stenosis [15,16]. However, there have been few studies of the 64-slice MDCT compared with IVUS for the evaluation of area stenosis of coronary stents.…”

Section: Discussionmentioning

confidence: 58%

In-stent area stenosis on 64-slice multi-detector computed tomography coronary angiography: optimal cutoff value for minimum lumen cross-sectional area of coronary stents compared with intravascular ultrasound

Kwon

Choi

Kim

et al. 2012

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

We aimed to prospectively assess the optimal cutoff value for a minimum lumen cross-sectional area (CSA) on a 64-slice multidetector computed tomography (MDCT) compared with an intravascular ultrasound (IVUS). In 39 patients with 43 stents, the minimum lumen diameter, stent diameter, diameter stenosis, minimum lumen CSA, stent CSA, and area stenosis at the narrowest point were measured independently on 64-slice MDCT and IVUS images. For the assessment of diameter and CSA, 64-slice MDCT showed good correlations with IVUS (r = 0.82 for minimum lumen diameter, r = 0.66 for stent diameter, r = 0.79 for minimum lumen CSA, and r = 0.75 for stent CSA, respectively, P < 0.0001). For the assessment of diameter and area stenoses, a 64-slice MDCT showed good correlations with IVUS (r = 0.89 and 0.91, respectively, P < 0.0001). The overall sensitivity, specificity, positive predictive value, and negative predictive value to detect in-stent area restenosis (≥ 50 % area stenosis) of a 64-slice MDCT were 77, 100, 100, and 91 %, respectively. The cutoff value of a 64-slice MDCT, determined by receiver operator characteristic (ROC) analysis, was 5.0 mm(2) with 76.5 % sensitivity and 92.3 % specificity for significant in-stent area restenosis; the area under the ROC curve was 0.902 (P < 0.0001). A good correlation was found between a 64-slice MDCT and the IVUS, regarding the assessment of diameter and area stenoses of coronary stents in selected patients implanted with stents of more than 3 mm in diameter. Optimal cutoff value for the minimum lumen CSA of coronary stents on the 64-slice MDCT is 5 mm(2) to predict a CSA of 4 mm(2) on IVUS.

show abstract

Section: Discussionmentioning

confidence: 58%

In-stent area stenosis on 64-slice multi-detector computed tomography coronary angiography: optimal cutoff value for minimum lumen cross-sectional area of coronary stents compared with intravascular ultrasound

Kwon

Choi

Kim

et al. 2012

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

show abstract

“…Methods applied for our analysis differ significantly from all of the previous studies exploring the relationship between calcifications and diagnostic accuracy of CTCA, which relied on the suboptimal reference of invasive angiography [12–15]. Invasive angiography does not provide optimal stenosis assessment within ostia or bifurcations (a frequent site of coronary calcifications), mainly due to the limited number of projections [12–15].…”

Section: Discussionmentioning

confidence: 99%

Lumen and calcium characteristics within calcified coronary lesions. Comparison of computed tomography coronary angiography intravascular ultrasound

Noll

Kruk

Pręgowski

et al. 2013

pwki

View full text Add to dashboard Cite

IntroductionComputed tomography coronary angiography (CTCA) is a diagnostic method used for exclusion of coronary artery disease. However, lower accuracy of CTCA in assessment of calcified lesions is a significant factor impeding applicability of CTCA for assessment of coronary atherosclerosis.AimTo provide insight into lumen and calcium characteristics assessed with CTCA, we compared these parameters to the reference of intravascular ultrasound (IVUS).Material and methodsTwo hundred and fifty-two calcified lesions within 97 arteries of 60 patients (19 women, age 63 ±10 years) underwent assessment with both 2 × 64 slice CT (Somatom Definition, Siemens) and IVUS (s5, Volcano Corp.). Coronary lumen and calcium dimensions within calcified lesions were assessed with CTCA and compared to the reference measurements made with IVUS.ResultsOn average CTCA underestimated mean lumen diameter (2.8 ±0.7 mm vs. 2.9 ±0.8 mm for IVUS), lumen area (6.4 ±3.4 mm2 vs. 7.0 ±3.7 mm2 for IVUS, p < 0.001) and total calcium arc (52 ±35° vs. 83 ±54°). However, analysis of tertiles of the examined parameters revealed that the mean lumen diameter, lumen area and calcium arc did not significantly differ between CTCA and IVUS within the smallest lumens (1st tertile of mean lumen diameter at 2.1 mm, and 1st tertile of lumen area at 3.7 mm2) and lowest calcium arc (mean of 40°).ConclusionsAlthough, on average, CTCA underestimates lumen diameter and area as well as calcium arc within calcified lesions, the differences are not significant within the smallest vessels and calcium arcs. The low diagnostic accuracy of CTCA within calcified lesions may be attributed to high variance and not to systematic error of measurements.

show abstract

“…However, recent studies have shown that MSCT and IVUS have similar sensitivity to detect significant and nonsignificant plaques in proximal coronary system [3,23,24]. Furthermore, a high degree of correlation was found between MSCT and IVUS regarding the assessment of minimal lumen diameter and area, lumen area stenosis and plaque burden as well as plaque characterization in patients with angiographically borderline LMCA stenosis [31].…”

Section: Study Limitationsmentioning

confidence: 96%

Prevalence of left main coronary artery disease among patients referred to multislice computed tomography coronary examinations

Gemici

Güneysu²,

Eroğlu

et al. 2008

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

We have evaluated the prevalence of left main coronary artery disease (LMCAD) among patients referred to multislice computed tomography (MSCT) coronary angiography examinations. The study Group comprised of 1,000 consecutive patients (750 male and 250 female; mean age 53+/-12 years) who underwent successful 64-slice MSCT examinations. Left main coronary artery (LMCA) was classified into three Groups: normal LMCA; nonsignificant LMCAD with coronary plaques resulting in obstructions 50%. We have found that 24 patients (2.4%) had significant LMCAD. Additional 200 patients (20%) had nonsignificant LMCAD. Univariate analysis revealed that LMCAD was associated with age, male gender, diabetes, hypertension, hyperlipidemia, typical symptoms, history of previous myocardial infarction and previous percutaneous coronary intervention. Only age and male gender were found as independent predictors for LMCAD in multivariate analysis (P < 0.001 and P = 0.001, respectively,). Angiographic follow-up was avaliable for the 24 patients with significant LMCAD, and conventional coronary angiography confirmed the presence of significant LMCAD in all of these patients. Significant LMCAD was found in 2.4% of the 1,000 patients referred to 64-slice MSCT examinations. Age and male gender were the independent predictors for LMCAD.

show abstract

Angiographically uncertain left main coronary artery narrowings: correlation with multidetector computed tomography and intravascular ultrasound

Cited by 24 publications

References 28 publications

In-stent area stenosis on 64-slice multi-detector computed tomography coronary angiography: optimal cutoff value for minimum lumen cross-sectional area of coronary stents compared with intravascular ultrasound

In-stent area stenosis on 64-slice multi-detector computed tomography coronary angiography: optimal cutoff value for minimum lumen cross-sectional area of coronary stents compared with intravascular ultrasound

Lumen and calcium characteristics within calcified coronary lesions. Comparison of computed tomography coronary angiography intravascular ultrasound

Prevalence of left main coronary artery disease among patients referred to multislice computed tomography coronary examinations

Contact Info

Product

Resources

About