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

J E Van Velzen,M A De Graaf,J W Jukema,E E Van Der Wall,L J Kroft,J D Schuijf,J H C Reiber,A De Roos,J J Bax,F R De Graaf,M J Schalij,A Ciarka

doi:10.1007/s10554-012-0015-7

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

J E Van Velzen, M A De Graaf + Show 10 more

Open Access

https://doi.org/10.1007/s10554-012-0015-7

Copy DOI

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.

Highlights

Invasive coronary angiography (ICA) has been traditionally used for evaluation of the presence and severity of coronary artery disease (CAD)
More accurate lesion assessment may be feasible with computed tomography angiography (CTA) as compared to invasive coronary angiography (ICA)
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

Summary

Introduction

Invasive coronary angiography (ICA) has been traditionally used for evaluation of the presence and severity of coronary artery disease (CAD). ICA has an excellent ability to visualize the lumen and severity of luminal narrowing, the presence of atherosclerotic plaque in the arterial wall cannot be accurately visualized [1]. Multidetector computed tomography angiography (CTA) is increasingly used to non-invasively evaluate the presence of CAD [7, 8], and a growing number of patients referred for ICA will have previously undergone non-invasive evaluation by CTA. A particular strength of this modality is that it is able to visualize luminal narrowing and the extent of atherosclerotic plaque in the arterial wall [9, 10]. In patients with previous CTA, who subsequently underwent ICA and PCI, lesion length on CTA was compared to length on ICA

Methods

Results

Conclusion