Loading…

Revisiting late loss and neointimal volumetric measurements in a drug-eluting stent trial: Analysis from the SPIRIT FIRST trial

This study was conducted to reevaluate the significance of angiographic late loss and to assess the agreement between new proposed neointimal volumetric measurements derived from quantitative coronary angiography (QCA) and standard intravascular ultrasound (IVUS)–based parameters. Neointimal volumet...

Full description

Saved in:
Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2006-02, Vol.67 (2), p.188-197
Main Authors: Tsuchida, Keiichi, García-García, Héctor M., Ong, Andrew T.L., Valgimigli, Marco, Aoki, Jiro, Rademaker, Tessa A.M., Morel, Marie-Angèle M., van Es, Gerrit-Anne, Bruining, Nico, Serruys, Patrick W.
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:This study was conducted to reevaluate the significance of angiographic late loss and to assess the agreement between new proposed neointimal volumetric measurements derived from quantitative coronary angiography (QCA) and standard intravascular ultrasound (IVUS)–based parameters. Neointimal volumetric measurements may better estimate the magnitude of neointimal growth after stenting than late loss. In 56 in‐stent segments (27, everolimus; 29, bare metal) in the SPIRIT FIRST study, we compared QCA measures with the corresponding IVUS parameters. Two IVUS‐late loss models were derived from minimal luminal diameter (MLD) using either a circular model or a so‐called projected MLD. QCA‐neointimal volume was calculated as follows: stent volume (mean area of the stented segment × stent length) at post procedure − lumen volume (mean area of the stented segment × stent length) at follow‐up (the stent length either from nominal stent length or the length measured by QCA). Videodensitometric neointimal volume was also evaluated. Each of the three neointimal volume and percentage volume obstruction by QCA showed significant correlation with the corresponding IVUS parameters (r = 0.557–0.594, P < 0.0001), albeit with a broad range of limits of agreement. Late loss and volumetric measurements by QCA had a broader range of standard deviation than those by IVUS. QCA‐volumetric measurements successfully confirmed the efficacy of everolimus‐eluting stents over bare metal stents (P < 0.05). Our proposed QCA volumetric measurements may be a practical surrogate for IVUS measurements and a discriminant methodological approach for assessment of treatment effects of drug‐eluting stents. © 2006 Wiley‐Liss, Inc.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.20581