OBJECTIVES: To propose and validate a novel approach to determine the optimal angiographic viewing angles for a selected coronary (target) segment from X-ray coronary angiography, without the need to reconstruct the entire coronary tree in three-dimensions (3D), such that subsequent interventions are carried out from the best view.
METHODS: The approach starts with standard quantitative coronary angiography (QCA) of the target vessel in two angiographic views. Next, the target vessel is reconstructed in 3D, and in a very simple and intuitive manner, the possible overlap of the target vessel and other vessel segments can be assessed, resulting in the best view with minimum foreshortening and overlap. A retrospective study including 67 patients was set up for the validation. The overlap prediction result was compared with the true overlap on the available angiographic views (TEST views). The foreshortening for the views proposed by the new approach software viewing angle (SVA) and the views used during the stent deployment software viewing angle (EVA) were compared. Two experienced interventional cardiologists visually evaluated the success of SVA with respect to EVA. The evaluation results were graded into five values ranging from -2 to 2.
RESULTS: The overlap prediction algorithm successfully predicted the overlap condition for all 235 TEST views. EVA was associated with more foreshortening than SVA (8.9%±8.2% vs. 1.6%±1.5%, p<0.001). The average evaluated point for the success of SVA was 0.94±0.80 (p <0.001), indicating that the evaluators were in favor of the optimal views determined by the proposed approach versus the views used during the actual intervention.
CONCLUSIONS: The proposed approach is able to accurately and quickly determine the optimal viewing angles for the online support of coronary interventions.
PMID: 21550911
See post from March 13th:
Potential role of three-dimensional rotational angiography and C-arm CT for valvular repair and implantation.
Schwartz JG, Neubauer AM, Fagan TE, Noordhoek NJ, Grass M, Carroll JD.
Int J Cardiovasc Imaging. 2011 Mar 11.
PMID: 　
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check also:
International Journal of Cardiovascular Imaging
Volume 27, Number 2 / February 2011
QCA, IVUS and OCT in Interventional Cardiology – 2011
Guest Editors: Hiram G. Bezerra, R.A. Costa and H.M. Garcia-Garcia
153-154
EDITORIAL NOTE
Introduction to QCA, IVUS and OCT in interventional cardiology
Johan H. C. Reiber
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155-156
EDITORIAL
QCA editorial
Ricardo A. Costa and Johan H. C. Reiber
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157-165
ORIGINAL PAPER
Novel QCA methodologies and angiographic scores
Vivian G. Ng and Alexandra J. Lansky
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167-174
ORIGINAL PAPER
Dedicated bifurcation analysis: basic principles
Joan C. Tuinenburg, Gerhard Koning, Andrei RareÅŸ, Johannes P. Janssen and Alexandra J. Lansky, et al.
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175-180
ORIGINAL PAPER
Quantitative coronary analysis in the Nordic Bifurcation studies
Niels R. Holm, Helle Højdahl, Jens F. Lassen, Leif Thuesen and Michael Maeng
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181-188
ORIGINAL PAPER
Dedicated bifurcation analysis: dedicated devices
Carlos Collet, Ricardo A. Costa and Alexandre Abizaid
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189-196
ORIGINAL PAPER
Bifurcation lesion morphology and intravascular ultrasound assessment
Ricardo A. Costa, Marco A. Costa and Issam D. Moussa
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197-207
ORIGINAL PAPER
Fusion of 3D QCA and IVUS/OCT
Shengxian Tu, Niels R. Holm, Gerhard Koning, Zheng Huang and Johan H. C. Reiber
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209-214
EDITORIAL
Ultrasound and light: friend or foe? On the role of intravascular ultrasound in the era of optical coherence tomography
Jennifer Huisman, Marc Hartmann and Clemens von Birgelen
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215-224
ORIGINAL PAPER
IVUS-based imaging modalities for tissue characterization: similarities and differences
Hector M. Garcìa-Garcìa, Bill D. Gogas, Patrick W. Serruys and Nico Bruining
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225-237
ORIGINAL PAPER
Assessment of coronary atherosclerosis by IVUS and IVUS-based imaging modalities: progression and regression studies, tissue composition and beyond
Bill D. Gogas, Vasim Farooq, Patrick W. Serruys and Hector M. Garcìa-Garcìa
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239-248
ORIGINAL PAPER
Assessment of drug-eluting stents and bioresorbable stents by grayscale IVUS and IVUS-based imaging modalities
Salvatore Brugaletta, Jose Ribamar Costa and Hector M. Garcia-Garcia
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249
EDITORIAL
OCT section
Hiram Grando Bezerra and Marco A. Costa
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251-258
REVIEW
Intracoronary optical coherence tomography, basic theory and image acquisition techniques
F. Prati, M. W. Jenkins, A. Di Giorgio and A. M. Rollins
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259-269
ORIGINAL PAPER
Assessment of coronary stent by optical coherence tomography, methodology and definitions
Emile Aziz Mehanna, Guilherme Ferragut Attizzani, Hiroyuki Kyono, Michael Hake and Hiram Grando Bezerra
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271-287
REVIEW
Optical coherence tomography endpoints in stent clinical investigations: strut coverage
Satoko Tahara, Daniel Chamié, Motaz Baibars, Chadi Alraies and Marco Costa
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289-298
ORIGINAL PAPER
Plaque and thrombus evaluation by optical coherence tomography
Takashi Kubo, Chenyang Xu, Zhao Wang, Nienke S. van Ditzhuijzen and Hiram G. Bezerra
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299-308
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Utilization of frequency domain optical coherence tomography and fractional flow reserve to assess intermediate coronary artery stenoses: conciliating anatomic and physiologic information
Gregory T. Stefano, Hiram G. Bezerra, Guilherme Attizzani, Daniel Chamié and Emile Mehanna, et al.
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Paul,
Do interventionalists really have such trouble at determining angles without the assistance of an algorithm like the one proposed? The authors describe: “In 89.6% of target vessels the proposed approach was able to determine the optimal viewing angles with less than 3% foreshortening and without overlap with major coronary branches which could influence the visibility of the target vessel. On the other hand, the experienced interventionalists were able to select a view with less than 3% foreshortening in only 28.4% target vessels and with more than 10% foreshortening in 38.8% target vessels. ”
What do you think?
Check also:
In vivo assessment of bifurcation optimal viewing angles and bifurcation angles by three-dimensional (3D) quantitative coronary angiography.
Tu S, Jing J, Holm NR, Onsea K, Zhang T, Adriaenssens T, Dubois C, Desmet W, Thuesen L, Chen Y, Reiber JHC.
Int J Cardiovasc Imaging. Epub Ahead of Print, DOI: 10.1007/s10554-011-9996-x.
Open Accessed, Available at: http://www.springerlink.com/content/r46831731544567w/