Stent sizing by coronary CT angiography compared with optical coherence tomography

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology

Background:

• Coronary CT angiography (CCTA) is established for coronary artery disease (CAD) diagnosis.
• Its role in guiding percutaneous coronary interventions (PCI) and stent sizing remains unclear.

Purpose of the Study:

• To evaluate the accuracy of CCTA in assessing reference vessel diameter for stent sizing.
• To compare CCTA-derived stent size with optical coherence tomography (OCT) measurements.

Main Methods:

• Sub-analysis of the Precise Percutaneous Coronary Intervention Plan (P3) study.
• Compared CCTA and OCT assessments in 65 coronary vessels.
• Analyzed agreement using Kappa statistics, Passing-Bablok regression, and Bland-Altman methods.

Main Results:

• CCTA and OCT showed similar distal reference lumen diameters (2.75 ± 0.53 mm vs. 2.72 ± 0.55 mm).
• No significant proportional or systematic differences were found between CCTA and OCT.
• Substantial agreement (Cohen's Kappa 0.74) was observed between CCTA- and OCT-guided stent sizes.

Conclusions:

• CCTA accurately assesses reference vessel diameter for stent sizing.
• CCTA-based stent sizing demonstrates substantial agreement with OCT.
• CCTA can aid in percutaneous coronary intervention planning and stent selection.