Assessment of coronary angioplasty by an automated digital angiographic method

Katritsis, D.; Lythall, D; Anderson, Mark; Cooper, Ian; Webb-Peploe, M M

doi:10.1016/0002-8703(88)90437-1

Cited by 48 publications

(15 citation statements)

References 23 publications

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“…Our results are similar to those observed in other studies 9,11,22,34 , however their objective and design were much different so hampering the determination of a suitable pattern for estimating the precision of the method employed. Under the impact of the appearance of coronary angioplasty, several studies proposing to enhance reliability of the interpretation of CCG have been published [10][11][12][13][15][16][17][18] . Technological developments led to improvement in quantitative digital analysis methodology and evolution of their indexes of reproducibility 14,27,35,36 .…”

Section: Discussionmentioning

confidence: 99%

“…The large margin of variability, especially for results expressed in terms of percent values, has become evident. Although some authors [10][11][12][13] have suggested alternative approaches aimed at increasing the precision of visual estimates, application of quantitative digital analysis has become a standard in scientific literature [13][14][15][16][17][18] . Yet, the use of this method in clinical practice is not automatic.…”

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confidence: 99%

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Reliability of the interpretation of coronary angiography by the simple visual method

Guimarães¹,

Victor²,

Leite³

et al. 2000

Arq. Bras. Cardiol.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Reliability of the interpretation of coronary angiography by the simple visual method

Guimarães¹,

Victor²,

Leite³

et al. 2000

Arq. Bras. Cardiol.

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“…Angiography remains the standard technique of assessing the cosmetic result of angioplasty; however, it can be the subject of considerable error (Katritsis et al 1988). This is particularly true immediately following the angioplasty procedure, when haziness caused by intimal flaps can make visual assessment that more difficult (Gehani et al 1990).…”

Section: Discussionmentioning

confidence: 99%

Value of a radionuclide limb blood flow technique in the assessment of percutaneous balloon and dynamic angioplasty

et al. 1992

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In a prospective study, a radionuclide technique was used to evaluate the limb blood flow (LBF) changes in 30 patients undergoing dynamic (n = 15) or balloon (n = 15) angioplasty for arterial occlusions or stenoses, respectively. The results were compared with Doppler Ankle Brachial Index (DABI) and treadmill exercise tests. Whilst LBF values (ml of blood flow per 100 ml of limb volume per min) were significantly lower in limbs with arterial occlusion than stenosis (4.5 +/- 0.46 and 6.4 +/- 0.74, respectively; P less than 0.05). DABI provided no discrimination. Immediately after balloon angioplasty, there was a fall in DABI, from 0.60 +/- 0.05 to 0.47 +/- 0.04 (P less than 0.05), which rose 24 h later to 0.73 +/- 0.02 (P less than 0.01). Following dynamic angioplasty, DABI improved from 0.60 +/- 0.05 to 0.66 +/- 0.02 (P less than 0.05). At 3 weeks, the LBF improved from 4.6 +/- 0.66 to 11.1 +/- 0.53 (P less than 0.001) following dynamic angioplasty and from 6.2 +/- 0.68 to 8.53 +/- 0.81 (P less than 0.001) following balloon angioplasty. "Normal" LBF (greater than 10 ml/100 ml per min) was achieved in 80% of patients who underwent successful dynamic angioplasty but in only 36% of the balloon group (P less than 0.05, chi 2-test). Reproducibility of repeated LBF measurements in control limbs was superior to that of DABI. This was indicated by a lower coefficient of variation, 13.8% compared with 25.2%, and a higher correlation coefficient, r = 0.79 compared with 0.27. Treadmill exercise tests were invalid or impossible in 30% of all occasions.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…One alternative available today is cine-video-densitometry which is supposed to measure the percent area stenosis from only one view. However, there are still many methodologic problems in cine-videodensitometry which shall not be discussed here [63][64][65][66].…”

Section: Discussionmentioning

confidence: 99%

International nifedipine trial on anti-atherosclerotic therapy (INTACT) — methodologic implications and results of a coronary angiographic follow-up study using computer-assisted film analysis

et al. 1990

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Animal experiments demonstrated a significant suppressive effect of various calcium channel blockers on the formation of atherosclerotic lesions. Therefore, a prospective, placebo-controlled, randomized, double blind multicenter study was performed to investigate the inhibitory influence of the calcium channel blocker nifedipine (80 mg/day) on the progression of coronary artery disease in man. Study endpoints were changes of coronary morphology documented by coronary angiography with particular respect to the formation of new coronary stenoses. In 348 out of 425 patients included in the study, coronary angiograms were repeated after three years. The angiograms were standardized by induction of a maximal coronary vasodilation with high doses of nitrates and by using absolutely identical angiographic projections. Quantitative analysis of coronary cineangiograms was performed with the computer-assisted contour detection system CAAS. Parameters were mean and minimal diameter of all segments and minimal stenosis diameter, percent diameter stenosis, length and plaque area of all stenoses.Continuous intake of study medication was registered in 282 patients, 134 on nifedipine and 148 patients on placebo. In these patients, a total of 3808 coronary segments with 893 stenoses (i> 20% diameter reduction in at least one angiographic projection) were compared on the baseline and follow-up cineangiograms. The changes in all angiographic parameters analyzed averaged over all patients by considering all angiographic projections analyzed, indicated significant progression of the disease (p < 0.006). The average changes in all parameters were even about three times more profound, when in the individual patients only the respective projections indicating the maximal changes were considered for the calculation (p < 0.001). However, with neither of these two analysis modes, the differences in progression between the treatment groups were statistically significant.In the follow-up angiograms, a total of 196 new coronary lesions (185 stenoses, 11 occlusions) were found at previously normal arterial sites. In patients on nifedipine, an average of only 0.58 new lesions per patient were detected versus 0,80 lesions per patient on placebo (-27%; p = 0.031).INTACT is the first prospective angiographic trial on the progression of coronary artery disease using computer-assisted quantitative coronary angiography in such a high number of patients. All parameters analyzed indicated significant progression of coronary artery sclerosis. Nifedipine had no influence on the progression of preexisting coronary stenoses, but inhibited significantly the formation of new angiographically recognizable lesions. Further prospective coronary angiographic trials with calcium channel blockers using a comparably exact method are needed to confirm the results of this study.

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Assessment of coronary angioplasty by an automated digital angiographic method

Cited by 48 publications

References 23 publications

Reliability of the interpretation of coronary angiography by the simple visual method

Reliability of the interpretation of coronary angiography by the simple visual method

Value of a radionuclide limb blood flow technique in the assessment of percutaneous balloon and dynamic angioplasty

International nifedipine trial on anti-atherosclerotic therapy (INTACT) — methodologic implications and results of a coronary angiographic follow-up study using computer-assisted film analysis

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