Coronary lesions quantification with dual-axis rotational coronary angiography

• Published in: Cardiovascular revascularization medicine 2013, Vol.14 (1), p.37-40
• Main Authors: Unzué Vallejo, Leire, Delcán Domínguez, Juan Luis, Alegría Barrero, Ana, Medina Peralta, Juan, Rodríguez Rodrigo, Francisco José, Rodríguez-López, Jose Luis
• Format: Article
• Language: English
• Subjects: Cardiovascular; Contrast Media; Coronary Angiography - methods; Coronary intervention; Coronary lesions assesment; Coronary Stenosis - diagnostic imaging; Coronary Vessels - diagnostic imaging; Humans; Ioxaglic Acid; Observer Variation; Predictive Value of Tests; Quantitative coronary angiography; Radiographic Image Interpretation, Computer-Assisted; Reproducibility of Results; Rotational angiography; Severity of Illness Index; Stent; Triiodobenzoic Acids
• ISSN: 1553-8389; 1878-0938
• DOI: 10.1016/j.carrev.2012.11.001

Abstract Background Coronary angiography (CA) has been the gold standard technique for studying coronary artery disease. It is based on the analysis of bidimensional orthogonal projections that may not be optimal to estimate determinate coronary segments. Rotational angiography “Xperswing” (DARCA) is a new technique that allows the visualization of the coronary arteries from multiple views, with a single contrast injection. The aim of this study is to evaluate the coronary lesions quantification with DARCA. Methods Quantitative coronary analysis of significant coronary stenosis (> 50%) was performed. Every lesion was measured in two different projections: the “optimal projection”, obtained by DARCA and defined by the operator as the one with a better lesion qualification, and the “standard projection”, corresponding to the usual projection closer to the optimal one in obliquity and angulation. Measures were performed twice and by two independent operators. Intra- and inter-observer correlation was estimated by Kappa index and variables were compared with t Student test (SPSS 14.0). Results 205 lesions in 147 patients were analyzed. Kappa coefficient intra-observer was 0.80 and 0.86 respectively with an inter-observer correlation index of 0.72. Lesion length and maximal diameter of the vessel were significantly greater in the group of RA. In the segments analysis, calculated length was longer for the first diagonal branch, first marginal obtuse artery, middle circumflex, middle and distal RCA and posterior descending artery, with greater reference diameters for proximal LAD and distal RCA. There were no significant differences for coronary stenosis grade. Conclusions RA XperSwing provides a better visualization of coronary arteries improving lesions characterization, with longer measured lesions length and greater vessel diameters, especially in coronary segments with more angulation.