Quantitative Coronary Analysis Compared to Intravascular Ultrasound in the Assessment of Coronary Lesions and Evaluation of Stent Expansion during Elective Percutaneous Coronary Interventions
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- Category: Vol. 85, June 2017
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Quantitative Coronary Analysis Compared to Intravascular Ultrasound in the Assessment of Coronary Lesions and Evaluation of Stent Expansion during Elective Percutaneous Coronary Interventions, MOHAMED LAIMOUD, YASSER NASSAR, WALID OMAR, AKRAM ABDELBARRY and HELMY EL-GHAWABY
Abstract
Background: Quantitative Coronary Analysis (QCA) allows an objective and independent parameter for the assess-ment of stenosis severity [1]. Intravascular ultrasound (IVUS) can detect atherosclerotic compromise in coronary segments where conventional angiography cannot. However, IVUS is more invasive and expensive than angiography [2].
Aim of Work: Comparison of coronary lesions assessment during percutaneous interventions by QCA and IVUS and stent diameters obtained by the 2 modalities were admitted in the Critical Care Department, Cairo University in the time period from June 2013 to August 2014.
Methodology: Thirty coronary lesions were evaluated (RVD, MLD, percent lesion stenosis) using QCA and IVUS before elective stenting procedures. The measurements of mean ± standard deviations of (Max SD, Min SD, Mean SD, stent symmetry index) using QCA and IVUS after stent deployment were compared in the evaluation of stent expan-sion.
Results: QCA was positively correlated with IVUS mea-surements of maximal vessel diameter (p 0.003 and r 0.49) and minimal vessel diameter (p 0.001 and r 0.57). QCA was not correlated with IVUS measurements of MLD (p 0.78 and r 0.05) and percent diameter stenosis (p 0.6 and r 0.09). The Max SD was (3.45±0.62 vs 2.97±0.59, p 0.009) and the Min SD was (2.77±0.53 vs 1.88±0.60, p 0.001) by IVUS vs QCA respectively. The mean SD was (3.18±0.64 vs 2.61±0.50, p 0.001) by IVUS vs QCA respectively. QCA was positively correlated with IVUS measurements of Max SD correlation (p<0.0001 & r 0.69), Min SD (p<0.0001 & r 0.63) and mean SD (p<0.0001 & r 0.67).
Conclusions: QCA was not accurate in coronary lesion assessment in comparison to IVUS and underestimated the stent diameters during stent deployment.