title: Discrepancies in vessel sizing between angiography and intravascular ultrasound varies according to the vessel evaluated.
abstract: OBJECTIVE
  Quantitative coronary analysis (QCA) of the coronary artery and stent size may be influenced by anatomical location in relation to both calibration point and the X-ray tube. The impact of this phenomenon on lesion assessment is undetermined.
  
  
  METHODS
  In total, 427 consecutive patients who underwent PCI with intravascular ultrasound (IVUS)-guidance were enrolled. The minimum stent diameter (MSD) was measured using QCA (MSDQCA) and IVUS (MSDIVUS) analysis. We used reference objects positioned at a different height from the X-ray source to validate our approach.
  
  
  RESULTS
  A statistically positive moderate correlation was observed between MSDQCA and MSDIVUS (r=0.649, p=0.001). The mean MSDQCA and MSDIVUS were 3.04±0.49 mm and 2.68±0.47 mm respectively. The difference between MSDQCA and MSDIVUS of >0.75 mm was more frequently observed in the LCx rather than in the LAD (7.4% in the LAD vs. 24.3% in the LCx, p=0.001). The discrepancy between the MSDQCA and MSDIVUS for the LCx was larger than for the LAD, and tended to be larger than for the RCA (13.3% vs. 18.5%, p=0.05 and 18.5% vs. 14.5%, p=0.17). A discrepancy >20% was more frequently observed in the small (≤2.5 mm) than in the large MSDIVUS group (52.7% vs. 25.1%, p=0.001). This discrepancy was more common in the LCx than in the LAD or RCA (48.6% vs. 30.9% vs. 31.2%, p=0.03).
  
  
  CONCLUSIONS
  Assessment of the MSDQCA is more likely to overestimate in the LCx than in the LAD, particularly when the MSDIVUS is <2.5 mm. Therefore, we should be less aggressive in oversizing balloons and stents based on QCA for the LCx or small vessel intervention.
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy; Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy; Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Takagi
authors.forename: Joanne
authors.initials: J
authors.lastname: Shannon
authors.forename: Sandeep
authors.initials: S
authors.lastname: Basavarajaiah
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.forename: Rasha
authors.initials: R
authors.lastname: Al-Lamee
authors.forename: Tasuku
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Cosmo
authors.initials: C
authors.lastname: Godino
authors.forename: Massimo
authors.initials: M
authors.lastname: Ferraro
authors.forename: Filippo
authors.initials: F
authors.lastname: Figini
authors.forename: Mauro
authors.initials: M
authors.lastname: Carlino
authors.forename: Matteo
authors.initials: M
authors.lastname: Montorfano
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000368:Aged; D015331:Cohort Studies; D017023:Coronary Angiography / Q000592:standards*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000592:standards*
keywords: Angiography; Discrepancy; Intravascular imaging; Lesion location; MSD