Methodologic Aspects of Quantitative Coronary Angiography (QCA) in Interventional Cardiology

Abstract

Quantitative Coronary Angiography (QCA) has had a tremendous impact in the field of interventional cardiology. It has supplanted visual and handheld caliper assessments of coronary arteriography due to its superior interobserver and intraobserver variability [1–3]. Currently it is the gold standard to assess the coronary tree for research purposes although it has not gained widespread appeal for routine clinical use because of expense and time constraints. It has been particularly useful in interventional cardiology as the only reliable means to assess the short and long term effects of coronary interventions. In particular, the phenomenon of restenosis has been primarily described and researched most extensively on the basis of sequential QCA studies. At the Thoraxcenter in Rotterdam, we have been advocating the importance of QCA since the first publication by our group in 1982 [4]. The system developed at the Thoraxcenter by Johan Reiber and colleagues, the Coronary Angiographic Analysis System (CAAS), has been extensively and rigorously validated [5–7]. In our database, we have now collected information from over 1700 patients who have undergone several different forms of non-operative coronary revascularization (Fig. 1). We have had to adapt the principles of QCA, which were initially designed for diagnostic studies to assess the extent of coronary artery disease, to more complicated and complex situations related to either the device or the effect of the intervention on the angiographic appearance of a damaged vessel.KeywordsEdge DetectionBalloon AngioplastyMethodologic AspectExpansion RatioElastic RecoilThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.