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Articles

Title: Quantitative coronary angiography and intravascular ultrasound assessment of coronary artery borderline lesions

Author:
Grzegorz Jan Horszczaruk, Janusz Kochman, Joanna Wilczyńska, Filip Diks, Marek Roik, Zenon Huczek, Grzegorz Opolski
Type:
Original articles
Language:
PL
Journal:
Polish Journal of Cardiology
Year:
2007
Volume:
9
Number:
5
Start page:
321
Final page:
326
ISSN:
1507-5540
Keywords:
intermediate coronary lesion, quantitive coronary angiography, intravascular ultrasound
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Introduction: Precise assessment of intermediate coronary lesions remains an important issue in every day clinical practice. lnvasive angiography, a golden standard of coronary artery anatomy evaluation, is not capable of direct identification of atherosclerotic plaque within the artery wali. lntravascular ultrasound (IVUS) allows visualization of both lumen and wali of coronary vessel. Aim of study: To compare angiographic and IVUS characteristics of intermediate coronary lesions. To assess the frequency of intermediate lesions that meet the significance criteria in IVUS. Material and methods: A group of 40 intermediate coronary lesions in 33 stable angina patients was studied. Percentage stenosis, minimal lumen diameter, reference diameter and lesion length were assessed with quantitive coronary angiography (QCA). IVUS measurements included minimal lumen area (MLA), minimal lumen diameter (MLD) and percentof area stenosis. Results: Mean percentage value of lumen narrowing reached the level of 46.59±9.22% in the entire group. MLA <4 mm2 was observed in case of 14 lesions (30%). MLD <1.8 mm was the least frequent indicator of lesion significance - 4 lesions (10%). Only 5% of studied lesion metali IVUS criteria of lesion significance.There was a significan tlinear correlation between minimal lumen diameter in angiography and MLA inlVUS(R=0.54; p<0.01). In the studied group there was no correlation between percentage lumen narrowing and IVUS criteria of lesion significance. Conclusions: In the studied group lesions that met all IVUS criteria of significance were observed with Iow frequency. In patients with lesions assessed by operators as angiographically borderline minimal lumen area <4 mm2 (the most often assumed single criterion of IVUS significance) was observed in only 30% of cases. Nevertheless, based on analysisof the studied group we cannot unambiguously establish angiographic predictors of lesion significance in IVUS.