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Published on: March 15, 2022
Validation of 4 French catheters for quantitative coronary analysis: in vivo variability assessment using 6 French
Marcelo Sanmartin1, Javier Goicolea, Raul Castellanos
1Interventional Cardiology Unit, Hospital Meixoeiro, Meixoeiro s/n, Vigo, Pontevedra, Spain, CP 36200. marcelo.sanmartin.fernandez@sergas.es
Insights
Four-French (4F) catheters are adequate for automatic quantitative coronary analysis, showing high accuracy and precision comparable to 6F catheters. This finding supports their use in routine follow-up assessments after percutaneous coronary interventions.
Area of Science:
- Cardiology
- Medical Imaging
- Interventional Cardiology
Background:
- Routine coronary angiography commonly utilizes 4 French (4F) catheters.
- The suitability of 4F catheters for automatic quantitative coronary analysis (QCA) remains under-assessed.
Purpose of the Study:
- To evaluate the adequacy of 4F catheters for QCA.
- To compare the quantitative analysis of coronary lesions using 4F and 6F catheters.
Main Methods:
- Coronary angiography was performed sequentially in 32 patients using 4F and 6F catheters.
- Quantitative analysis of 43 lesions was conducted, assessing reference diameter, minimal luminal diameter, and percent diameter stenosis.
- Intraobserver variability was assessed by re-evaluating 12 lesions.
Main Results:
- High accuracy and precision were observed for 4F catheters in measuring reference diameter (accuracy 0.009 mm, precision 0.17 mm), minimal luminal diameter (accuracy 0.005 mm, precision 0.19 mm), and percent diameter stenosis (accuracy 0.25%, precision 5.93%).
- Linear correlations for these parameters were strong (0.93-0.94).
- Intraobserver variability analysis confirmed consistent results.
Conclusions:
- Coronary angiography with 4F catheters provides adequate quantification of luminal diameters, aligning with clinical standards.
- These findings suggest 4F catheters are suitable for routine follow-up assessments of percutaneous coronary interventions (PCIs).
Unlabelled:
Although numerous studies have established the utility of 4 F catheters for routine coronary angiography, its adequacy for automatic quantitative coronary analysis has not been previously assessed.
Methods:
In 32 consecutive patients, coronary angiography was performed sequentially with 4 F diagnostic catheters and 6 F guiding catheters after intracoronary nitroglycerin. A total of 43 lesions were evaluated for quantitative analysis using both types of catheter as scaling devices. Possible differences in the reference diameter, minimal luminal diameter and percent diameter stenosis were evaluated. All measurements were performed offline by the same operator and intraobserver variability estimation was performed by repeating the evaluation in 12 lesions randomly selected after 1 month.
Results:
The mean reference diameter was 2.98+/-0.48 mm, mean minimal luminal diameter was 1.00+/-0.52 mm and percent diameter stenosis was 67.1+/-15.3%. Accuracy (mean difference of values) was 0.009 mm for reference diameter, 0.005 mm for minimal luminal diameter and 0.25% for percent diameter stenosis. Precision (mean standard deviation of the differences) was 0.17 mm for reference diameter, 0.19 mm for minimal luminal diameter and 5.93% for percent stenosis. Linear correlation for these three variables was 0.94, 0.93 and 0.93, respectively. Intraobserver variability analysis showed similar values for accuracy, precision and linear correlation.
Conclusions:
Angiography with 4 F catheters allows adequate quantification of luminal diameters as compared to most accepted clinical standards. These results may have implications for the selection of diagnostic catheters for routine follow-up assessment of percutaneous coronary interventions.
