Clinical assessment of a new real time 3D quantitative coronary angiography system: evaluation in stented vessel
Rainer Gradaus1, Klara Mathies, Günter Breithardt
1Department of Cardiology and Angiology, University Hospital Münster, Germany. gradaus@uni-muenster.de
Insights
The CardiOp-B System accurately measures coronary stent dimensions using 3D quantitative coronary angiography (QCA), overcoming foreshortening issues in standard angiography. This 3D QCA system provides reliable diagnostic information for interventional cardiologists.
Area of Science:
- Cardiovascular imaging
- Medical device technology
- Interventional cardiology
Background:
- Foreshortening in angiography hinders accurate coronary lesion analysis and 2D quantitative coronary angiography (QCA).
- The CardiOp-B System offers 3D reconstruction from two 2D angiographies for comprehensive analysis.
- It integrates real-time and offline processing as an add-on to conventional X-ray angiography.
Purpose of the Study:
- To evaluate the accuracy of the novel CardiOp-B System for 3D quantitative coronary angiography.
- To assess the system's ability to overcome limitations of 2D QCA caused by foreshortening.
Main Methods:
- 3D QCA was applied to 61 stents in 50 patients during high-pressure inflation.
- Measurements included proximal and distal stent diameter and stent length.
- Obtained values were correlated with predefined stent sizes at utilized inflation pressures.
Main Results:
- High linear correlation was found for proximal stent diameter (r(2) = 0.85) and distal stent diameter (r(2) = 0.81).
- Excellent linear correlation was observed for stent length (r(2) = 0.98).
- The system demonstrated strong agreement between measured and real stent dimensions.
Conclusions:
- The CardiOp-B System provides accurate 3D QCA measurements.
- It demonstrates high linear correlation between real and measured vessel dimensions.
- The system offers reliable diagnostic information without altering standard angiography procedures.
Background:
Foreshortening is a recognized problem that is present in angiography and results from views that are not perpendicular to coronary lesions. This limits visual coronary analysis as well as 2D quantitative coronary angiography systems (QCA). The CardiOp-B System is a 3D image acquisition and processing software system designed as an add-on to conventional X-ray angiography system. CardiOp-B's features include real time and off line analysis with comprehensive 3D reconstruction integrating all of the available information of two 2D vessel angiographies into one 3D image. It was the aim of the study to analyze the accuracy of this new 3D QCA system.
Methods:
3D QCA was performed in 50 patients (age 64 +/- 10.9; 84% male; LV-EF 63 +/- 16%) measuring 61 stents during high-pressure inflation (diameter: 2.25-4 mm; length: 8-32 mm). The obtained values (proximal and distal stent diameter, stent length) were correlated with the predefined size of the stents at the used inflation pressure.
Results:
The linear correlation for the proximal stent diameter was Stent(prox)= 0.03 + 0.93 x real stent size (r(2) = 0.85). The linear correlation for the distal stent diameter was Stent(distal)= -0.03 + 0.89 x real stent size (r(2) = 0.81). The linear correlation for the stent length was Stent(length)= -0.61 + 1.02 x real stent length (r(2) = 0.98).
Conclusions:
The CardiOp-B System(R) is a new 3D QCA system with a high linear correlation between the real vessel size and the obtained vessel dimension. It provides real time or off line accurate and comprehensive diagnostic information to the interventional cardiologist without changing the basic coronary angiography procedure.
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