Comparison between Three‐Dimensional Angiographic Reconstruction and Intravascular Ultrasound Imaging for the Measurement of Cross‐Sectional Luminal Dimensions in Intermediate Coronary Lesions

Background: Intravascular ultrasound (IVUS) has enabled the measurement of minimal luminal area of coronary stenoses. We evaluated the hypothesis that angiographic three-dimensional reconstruction of luminal dimensions may be able to provide similar measurements to IVUS in intermediate coronary lesions. Methods: We retrospectively enrolled patients undergoing invasive coronary angiography and IVUS for the assessment of angiographically intermediate coronary lesions (50–70%) at a high-volume tertiary care hospital between July 1, 2006, and May 20, 2008. IVUS (Boston Scientific, Natick Massachusetts, USA) minimal cross-sectional area (CSA) and minimal luminal diameters (MLD) were compared with the measurements obtained using a sophisticated three-dimensional angiographic reconstruction software (CardiOP-B, Paieon, Inc., Rosh Ha’ayin, Israel), with orthogonal angiographic views used to reconstruct and calculate lesion dimensions. Results: Data were obtained from 34 patients with 35 lesions. The lesions were assessed in the left main (n = 2), left anterior descending artery (n = 15), left circumflex/marginal artery (n = 7), and right coronary artery (n = 11). Using IVUS, the mean minimal CSA was 3.78 ± 1.60 mm2, and MLD was 1.88 ± 0.43 mm. Three-dimensional reconstruction measurements of minimal CSA (3.42 ± 1.66 mm2) highly correlated in a linear fashion with the measurements by IVUS (R = 0.88, P < 0.0001). Conclusions: A three-dimensional angiographic measurement of coronary minimal CSA is highly correlated with the measurements using IVUS. This new software technology may be a promising imaging modality to measure CSAs in coronary lesions.