Objectives: The aim of this study was to compare lesion dimensions as determined by a three‐dimensional quantitative coronary angiographic (QCA) system to that of a validated two‐dimensional QCA system.
Background: In an era of drug‐eluting stents, device sizing has become an important clinical application of online QCA. The CardiOp‐B system integrates two standard angiographic projections to provide a three‐dimensional reconstruction of the arterial segment of interest.
Methods: Phase 1 — 47 stenoses from consecutive coronary angiograms were assessed in two projections with both systems providing two data sets for the CMS‐Medis system and a single data set for CardiOp‐B. Phase 2 — a perspex phantom with a known lesion length, was analyzed at increasing degrees of foreshortening with acceptance criteria set at 5% from the absolute value.
Results: Phase 1 demonstrated an adequate correlation between the CardiOp‐B and Medis systems when minimal luminal diameter was measured in the optimal view (1.32 ± 0.47 mm vs 1.42 ± 0.49 mm respectively; r = 0.82). A stronger correlation was noted when length was measured (25.27 ± 10.76 mm and 21.32 ± 8.08 mm, respectively; r = 0.95); however CardiOp‐B provided a consistently longer length (P < 0.0001). On phantom length measurements the mean accuracy result for the CardiOp‐B system was −1.3%. This compared favorably with the two‐dimensional system where all measures performed at greater than 20 degrees of forshortening were beyond the 5% criteria from the known length.
Conclusions: Three‐dimensional QCA provides accurate and precise vessel diameter assessments. Length assessments are consistently longer than two‐dimensional measures and are significantly less affected by foreshortened projections. (J Interven Cardiol 2010;23:152‐159)