Three-dimensional reconstruction allows accurate quantification and length measurements of coronary artery stenoses

Aims: The aim of this prospective study was to evaluate the feasibility and accuracy of a recently developed 3D system (CardiOp-B; Paieon Medical Ltd., Israel) as compared to a validated quantitative coronary angiography (QCA) system (Siemens Quantcor, Siemens Medical Solutions). Methods and results: In patients scheduled for heart catheterisation, minimal lumen diameter (MLD) and diameter-derived percent stenosis (DPS) were obtained for CAS (>50%) using both QCA and the 3D-system. To estimate stenosis length, a non-inflated balloon was inserted into the stenosis and the distance between balloon markers was measured using both methods and then compared to the known distance between the markers. In 61 patients 79 lesions were analysed. MLD measurements showed a good agreement between QCA and 3D with a mean difference of 0.08 +/- 0.035 mm. Reference diameter was 2.61 +/- 0.67 for 3D and 2.42 +/- 0.61 mm for QCA and 54.79 +/- 9.20% vs. 58.75 +/- 8.15% for the %-stenosis range, respectively. The mean true balloon length was 12.8 mm +/- 3.8 mm. Lengths determined by the 3D system were 13.0 +/- 4.0 mm and 11.3 +/- 3.8 mm by QCA, respectively. Conclusions: Evaluation of CAS using the novel 3D system was feasible and showed equivalent results to validated QCA measurements. Length measurements seemed to be more accurate by the 3D system as compared to QCA. Therefore, this 3D-system can be used to guide decisions in interventional cardiology.