Intravascular ultrasound imaging of angiographically normal coronary arteries: An in vivo comparison with quantitative angiography

Abstract

Intravascular ultrasound, a new technique for real-time two-dimensional visualization of arteries and veins, delineates vessel wall morphology and measures luminal dimensions. This imaging method has been validated with in vitro systems and in peripheral vessels, but there are few in vivo coronary artery studies. Twenty cardiac transplant recipients with no angiographic coronary artery disease were scanned with a 30-MHz intravascular ultrasound catheter from the left main coronary ostium to the mid-left anterior descending coronary artery. Simultaneous angiographic measurements were performed at 76 sites. Ultrasound end-diastolic diameters in two perpendicular axes were 3.8 +/- 0.9 and 3.9 +/- 0.6 mm, respectively, and mean diameter derived from an area determined by planimetry was 3.9 +/- 0.9 mm. Angiographic coronary artery diameters measured with a computer-assisted edge detection system perpendicular to the long axis of the vessel and to the long axis of the catheter were 3.4 +/- 0.8 and 3.6 +/- 0.8 mm, respectively. Luminal diameters measured with the two imaging systems correlated closely, with an r value of 0.86 when ultrasound was compared with the angiographic diameter measured perpendicular to the vessel and 0.88 when compared with the angiographic diameter measured perpendicular to the imaging catheter. Eighty-three percent of the ultrasound-measured diameters were above the line of identity when compared with the simultaneous angiographic measurement. The more the imaging catheter deviated from the long axis of the vessel, the greater was the discrepancy between the ultrasound and angiographic measurements.(ABSTRACT TRUNCATED AT 250 WORDS)

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

“…13 In addition, IVUS has been useful in demonstrating diffuse disease in angiographically, 'normal' arteries, which may have as much as one-third of their cross-sectional area filled with diffuse plaque. 14,15 Does Intravascular Ultrasound Use Improve Outcomes?…”

Intravascular ultrasound imaging of coronary arteries. Is three layers the norm?

“…[8][9][10] Even with the excellent resolution afforded by 30-MHz images, we have noted that the three-layered appearance may be absent, particularly in the vessels from younger patients. On this basis, we hypothesized that a certain degree of intimal thickening may be necessary in order for the threelayered appearance to be manifested, i.e., that the three layers may not in fact represent the pattern from a truly normal coronary segment.…”

Factors That Influence Measurements and Accurate Evaluation of Stent Apposition by Optical Coherence Tomography Assessment Using a Phantom Model

“…14,15 In the case of IVUS, the impact of catheter angulation on vessel lumen measurements might be small because the size of the IVUS image catheter in relation to the coronary artery lumen is relatively large. 16 With the OCT image wire, however, non-coaxial imaging might occur more frequently because the image wire catheter is slimmer than the IVUS catheter. The second mechanism might be a deviation of the lateral resolution as the distance from the image wire increases, although the longitudinal axial resolution is unchanged.…”