Three-dimensional analysis of the left anterior descending coronary artery: comparison with conventional coronary angiograms.
OBJECTIVE
This study aimed at comparing three-dimensional (3-D) reconstruction with two-dimensional coronary angiograms with respect to anatomical parameters that might affect plaque formation and rupture.


METHODS
Sixty patients with stable left anterior descending (LAD) lesions and 60 patients with an anteroseptal myocardial infarction and recanalized LAD were studied.


RESULTS
Conventional angiography significantly underestimated the distance of the stenosis from the ostium of the LAD, 29.4+/-14.5 versus 35.3+/-18.5 mm, P<0.001. Vessel curvature at the site of the lesion was overestimated by conventional angiography compared with 3-D reconstruction, 147.6+/-30.6 degrees versus 162.3+/-11.2 degrees , P<0.001, as was axial bending of the LAD owing to ventricular contraction (17.8+/-7.78 degrees vs. 8.9+/-8.9 degrees , P<0.001). No agreement was observed between two-dimensional and 3-D analysis for either curvature on lesion or axial bending assessment, with intraclass correlation coefficient values 0.155 (-0.009, 0.315) and -0.022 (-0.183, 0.174), respectively. No significant agreement was found between the two methods in the detection of on-stenosis bifurcations (1.7%, kappa=0.086, P=0.349).


CONCLUSIONS
Conventional coronary angiography cannot provide accurate estimates of anatomical parameters, such as distance of a coronary stenosis from the ostium of the vessel, coronary artery curvature at the site of stenosis, axial deformity and bending because of ventricular contraction, and classification of bifurcations. Reconstruction of the coronary tree in 3-D space is necessary for such estimations.
Katritsis
Demosthenes G
DG
Department of Cardiology, Athens Euroclinic, Athens, Greece. dkatritsis@euroclinic.gr
Pantos
Ioannis
I
Efstathopoulos
Efstathios P
EP
Tzanalaridou
Efthalia
E
Korovesis
Socrates
S
Kourlaba
Georgia
G
Paxinos
George
G
Voridis
Eutychios
E
D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology