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The International Journal of Cardiovascular Imaging

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Open Access 01-12-2012 | Original Paper

Non-invasive assessment of atherosclerotic coronary lesion length using multidetector computed tomography angiography: comparison to quantitative coronary angiography

Authors: J. E. van Velzen, M. A. de Graaf, A. Ciarka, F. R. de Graaf, M. J. Schalij, L. J. Kroft, A. de Roos, J. W. Jukema, J. H. C. Reiber, J. D. Schuijf, J. J. Bax, E. E. van der Wall

Published in: The International Journal of Cardiovascular Imaging | Issue 8/2012

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Abstract

Multidetector computed tomography angiography (CTA) provides information on plaque extent and stenosis in the coronary wall. More accurate lesion assessment may be feasible with CTA as compared to invasive coronary angiography (ICA). Accordingly, lesion length assessment was compared between ICA and CTA in patients referred for CTA who underwent subsequent percutaneous coronary intervention (PCI). 89 patients clinically referred for CTA were subsequently referred for ICA and PCI. On CTA, lesion length was measured from the proximal to the distal shoulder of the plaque. Quantitative coronary angiography (QCA) was performed to analyze lesion length. Stent length was recorded for each lesion. In total, 119 lesions were retrospectively identified. Mean lesion length on CTA was 21.4 ± 8.4 mm and on QCA 12.6 ± 6.1 mm. Mean stent length deployed was 17.4 ± 5.3 mm. Lesion length on CTA was significantly longer than on QCA (difference 8.8 ± 6.7 mm, P < 0.001). Moreover, lesion length visualized on CTA was also significantly longer than mean stent length (CTA lesion length-stent length was 4.2 ± 8.7 mm, P < 0.001). Lesion length assessed by CTA is longer than that assessed by ICA. Possibly, CTA provides more accurate lesion length assessment than ICA and may facilitate improved guidance of percutaneous treatment of coronary lesions.

1.

Mintz GS, Painter JA, Pichard AD et al (1995) Atherosclerosis in angiographically “normal” coronary artery reference segments: an intravascular ultrasound study with clinical correlations. J Am Coll Cardiol 25(7):1479–1485PubMedCrossRef

2.

Fujii K, Carlier SG, Mintz GS et al (2005) Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study. J Am Coll Cardiol 45(7):995–998PubMedCrossRef

3.

Okabe T, Mintz GS, Buch AN et al (2007) Intravascular ultrasound parameters associated with stent thrombosis after drug-eluting stent deployment. Am J Cardiol 100(4):615–620PubMedCrossRef

4.

Liu XB, Qian JY, Zhang F et al (2009) Intravascular ultrasound assessment of sirolimus-eluting stent restenosis or thrombosis after stent implantation. Zhonghua Xin Xue Guan Bing Za Zhi 37(5):397–401PubMed

5.

Yamagishi M, Hosokawa H, Saito S et al (2002) Coronary disease morphology and distribution determined by quantitative angiography and intravascular ultrasound—re-evaluation in a cooperative multicenter intravascular ultrasound study (COMIUS). Circ J 66(8):735–740PubMedCrossRef

6.

Porter TR, Sears T, Xie F et al (1993) Intravascular ultrasound study of angiographically mildly diseased coronary arteries. J Am Coll Cardiol 22(7):1858–1865PubMedCrossRef

7.

Meijboom WB, van Mieghem CA, Mollet NR et al (2007) 64-slice computed tomography coronary angiography in patients with high, intermediate, or low pretest probability of significant coronary artery disease. J Am Coll Cardiol 50(15):1469–1475PubMedCrossRef

8.

Meijboom WB, Meijs MF, Schuijf JD et al (2008) Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study. J Am Coll Cardiol 52(25):2135–2144PubMedCrossRef

9.

Achenbach S, Moselewski F, Ropers D et al (2004) Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: a segment-based comparison with intravascular ultrasound. Circulation 109(1):14–17PubMedCrossRef

10.

Kass M, Glover CA, Labinaz M et al (2010) Lesion characteristics and coronary stent selection with computed tomographic coronary angiography: a pilot investigation comparing CTA, QCA and IVUS. J Invasive Cardiol 22(7):328–334PubMed

11.

Van Velzen JE, Schuijf JD, De Graaf FR et al (2009) Plaque type and composition as evaluated non-invasively by MSCT angiography and invasively by VH IVUS in relation to the degree of stenosis. Heart 95(24):1990–1996PubMedCrossRef

12.

Leber AW, Knez A, Becker A et al (2004) Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: a comparative study with intracoronary ultrasound. J Am Coll Cardiol 43(7):1241–1247PubMedCrossRef

13.

Hausleiter J, Meyer T, Hermann F et al (2009) Estimated radiation dose associated with cardiac CT angiography. JAMA 301(5):500–507PubMedCrossRef

14.

Soon KH, Farouque HM, Chaitowitz I et al (2007) Discrepancy between computed tomography coronary angiography and selective coronary angiography in the pre-stenting assessment of coronary lesion length. Australas Radiol 51(5):440–445PubMedCrossRef

15.

Bigi R, Cortigiani L, Colombo P et al (2003) Prognostic and clinical correlates of angiographically diffuse non-obstructive coronary lesions. Heart 89(9):1009–1013PubMedCrossRef

16.

Califf RM, Phillips HR III, Hindman MC et al (1985) Prognostic value of a coronary artery jeopardy score. J Am Coll Cardiol 5(5):1055–1063PubMedCrossRef

17.

Cashin-Hemphill L, Mack WJ, Pogoda JM et al (1990) Beneficial effects of colestipol-niacin on coronary atherosclerosis. A 4-year follow-up. JAMA 264(23):3013–3017PubMedCrossRef

18.

Schuler G, Hambrecht R, Schlierf G et al (1992) Regular physical exercise and low-fat diet. Effects on progression of coronary artery disease. Circulation 86(1):1–11PubMedCrossRef

19.

Butler J, Shapiro M, Reiber J et al (2007) Extent and distribution of coronary artery disease: a comparative study of invasive versus noninvasive angiography with computed angiography. Am Heart J 153(3):378–384PubMedCrossRef

20.

Becker CR, Nikolaou K, Muders M et al (2003) Ex vivo coronary atherosclerotic plaque characterization with multi-detector-row CT. Eur Radiol 13(9):2094–2098PubMedCrossRef

21.

Petranovic M, Soni A, Bezzera H et al (2009) Assessment of nonstenotic coronary lesions by 64-slice multidetector computed tomography in comparison to intravascular ultrasound: evaluation of nonculprit coronary lesions. J Cardiovasc Comput Tomogr 3(1):24–31PubMedCrossRef

22.

Schepis T, Marwan M, Pflederer T et al (2009) Quantification of noncalcified coronary atherosclerotic plaques with dual source computed tomography: comparison to intravascular ultrasound. Heart 96(8):610–615

23.

Nikolaou K, Becker CR, Muders M et al (2004) Multidetector-row computed tomography and magnetic resonance imaging of atherosclerotic lesions in human ex vivo coronary arteries. Atherosclerosis 174(2):243–252PubMedCrossRef

24.

Schroeder S, Kuettner A, Wojak T et al (2004) Non-invasive evaluation of atherosclerosis with contrast enhanced 16 slice spiral computed tomography: results of ex vivo investigations. Heart 90(12):1471–1475PubMedCrossRef

25.

Schroeder S, Kuettner A, Leitritz M et al (2004) Reliability of differentiating human coronary plaque morphology using contrast-enhanced multislice spiral computed tomography: a comparison with histology. J Comput Assist Tomogr 28(4):449–454PubMedCrossRef

26.

Mintz GS, Pichard AD, Kent KM et al (1998) Interrelation of coronary angiographic reference lumen size and intravascular ultrasound target lesion calcium. Am J Cardiol 81(4):387–391PubMedCrossRef

27.

Virmani R, Burke AP, Kolodgie FD et al (2003) Pathology of the thin-cap fibroatheroma: a type of vulnerable plaque. J Interv Cardiol 16(3):267–272PubMedCrossRef

28.

Virmani R, Kolodgie FD, Burke AP et al (2000) Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 20(5):1262–1275PubMedCrossRef

29.

Hecht HS (2008) Applications of multislice coronary computed tomographic angiography to percutaneous coronary intervention: how did we ever do without it? Catheter Cardiovasc Interv 71(4):490–503PubMedCrossRef

Title: Non-invasive assessment of atherosclerotic coronary lesion length using multidetector computed tomography angiography: comparison to quantitative coronary angiography
Authors: J. E. van Velzen
M. A. de Graaf
A. Ciarka
F. R. de Graaf
M. J. Schalij
L. J. Kroft
A. de Roos
J. W. Jukema
J. H. C. Reiber
J. D. Schuijf
J. J. Bax
E. E. van der Wall
Publication date: 01-12-2012
Publisher: Springer Netherlands
Published in: The International Journal of Cardiovascular Imaging / Issue 8/2012
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-012-0015-7

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