Utility of three-dimensional reconstruction of coronary angiography to guide percutaneous coronary intervention
Utility of three-dimensional reconstruction of coronary angiography to guide percutaneous coronary intervention
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DOI：
10.1002/ccd.20955
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发表时间：
2007-03-01
影响因子：
2.3
通讯作者：
Price, Matthew J.
中科院分区：
文献类型：
--
作者：
Gollapudi, Raghava R.;Valencia, Rafael;Price, Matthew J.
目的：本研究的目的是确定传统冠状动脉造影的三维（3D）重建是否可以优化经皮冠状动脉介入治疗（PCI）期间药物洗脱支架（DES）长度和数量的选择。背景资料：冠状动脉血管造影术容易出现明显的透视短缩伪影，这限制了术者准确确定病变长度的能力。方法：采用三维重建算法对连续PCI手术的靶血管造影图像进行后处理。计算跨越每个靶病变的DES的适当长度和最佳数量，并与术者实际选择的DES数量和长度进行比较。结果：共分析了42条靶血管，38/42（90.5%）例病例的3D重建成功。3D分析的结果可能改变了6例（16%）术者的决策：在4例病例中，术者选择的支架太短，需要额外的DES;在2例病例中，选择的DES太长，更换为较短的DES。在这6例病例中，3D分析将在支架选择之前确定正确的支架长度。通过3D重建得出的最佳支架数量明显少于术者使用的每个病变的实际支架数量（1.31 +/- 0.47 vs 1.54 +/- 0.68，P = 0.01），最佳支架长度趋向于小于实际支架长度（27.5 ± 12.8 mm vs 28.7 ± 14.7 mm，P = 0.23）。结论：标准冠状动脉造影的三维重建算法是一种有前途的技术，以提高DES在PCI术中的使用。(c)2006 Wiley-Liss，Inc.
Objective: The goal of this study was to determine whether three-dimensional (3D) reconstruction of traditional coronary angiography could optimize the choice of drug-eluting stent (DES) length and number during percutaneous coronary intervention (PCI). Background: Coronary angiography is subject to significant foreshortening artifact that limits the ability of the operator to accurately determine lesion length. Methods: The angiographic images of the target vessels of consecutive PCI procedures were postprocessed using a 3D reconstruction algorithm. The appropriate length and optimal number of DES to span each target lesion were calculated and compared with the number and length of DES actually chosen by the operator. Results: A total of 42 target Vessels were analyzed, and 3D reconstruction was successful in 38/42 (90.5%) of cases. The results of 3D analysis would have changed operator decision making in six cases (16%): in four cases, the stent chosen by the operator was too short requiring an additional DES; in two cases, the chosen DES was too long and exchanged for a shorter one. In each of these six cases, 3D analysis would have determined the correct stent length prior to stent selection. The optimal stent number derived by 3D reconstruction was significantly less than the actual number of stents per lesion used by the operator (1.31 +/- 0.47 versus 1.54 +/- 0.68, P = 0.01), and the optimal stent length trended less than the actual stented length (27.5 +/- 12.8 mm versus 28.7 +/- 14.7 mm, P = 0.23). Conclusions: 3D reconstruction algorithm of standard coronary angiography is a promising technique to improve DES utilization during PCI. (c) 2006 Wiley-Liss, Inc.