Clinical validation of intravascular ultrasound imaging for assessment of coronary stenosis severity: Comparison with stress myocardial perfusion imaging

Abstract

OBJECTIVESTo validate intravascular ultrasound (IVUS) measurements for differentiating functionally significant from nonsignificant coronary stenosis.BACKGROUNDTo date, there are no validated criteria for the definition of a flow-limiting coronary artery stenosis by IVUS.METHODSPreinterventional IVUS imaging (30-MHz imaging catheter) of 70 de novo coronary lesions was performed. The lesion lumen area and three IVUS-derived stenosis indixes comparing lesion lumen area with the lesion external elastic lamina (EEL) area, the mean reference lumen area and the mean reference EEL area were compared with the results of stress myocardial perfusion imaging.RESULTSThe lesion lumen area and three IVUS-derived stenosis indexes showed sensitivities and specificities ranging between 80% and 90% using stress myocardial perfusion imaging as the gold standard. The lesion lumen area ≤4 mm2is a simple and highly accurate criterion for significant coronary narrowing.CONCLUSIONSQuantitative IVUS indices can be reliably used for identifying significant epicardial coronary artery stenoses.