Accuracy of 3-dimensional and 2-dimensional quantitative coronary angiography for predicting physiological significance of coronary stenosis: a FAVOR II substudy

Abstract

Background: Three-dimensional quantitative coronary angiography (3D-QCA) enables reconstruction of a coronary artery in 3D from two angiographic image projections. This study compared the diagnostic accuracy of 3D-QCA vs. 2-dimensional (2D) QCA in predicting physiologically significant coronary stenosis, using fractional flow reserve (FFR) as the reference standard.Methods: All interrogated vessels in the FAVOR II China study and the FAVOR II Europe-Japan study were assessed by 2D-QCA and 3D-QCA according to standard operating procedures in core laboratories. QCA analysts were blinded to the corresponding FFR values.Results: A total of 645 vessels from 576 patients with 3D-QCA, 2D-QCA, and FFR were analyzed. Using the conventional cut-off value of 50% for percent diameter stenosis (DS%), 3D-QCA was more accurate in predicting FFR ≤0.80 than 2D-QCA [accuracy 74.

Non-invasive imaging software to assess the functional significance of coronary stenoses: a systematic review and economic evaluation

“…This search identified four such studies (see Appendix 4, Table 41). [62][63][64][65] Figure 9 shows the plot of all extracted data from these four studies. The colours of the dots indicate the studies.…”

“…Cliff and Ong (2019), 16 conference abstract Cliff et al 144 Cortés et al (2019) 17 Cortes Villar et al 145 and Cortes et al 146 Emori et al (2018) 20 Emori et al 20 Emori et al (2018) 21 Emori et al 147,148 and Tanigaki et al 149 FAST-EXTEND: Daemen et al (2019), 18 conference abstract Masdjedi et al 56 and Daemen 150 FAVOR II China: Xu et al (2017) 52 Ding et al, 62 Chang et al, 151 Fuwai Hospital 152 and Zhang et al 153 FAVOR II Europe-Japan: Westra et al (2018) 50 Holm 154 FAVOR pilot: Tu et al (2016) 46 Tu et al 155 l QFR ≤ 0.80: 18% l QFR > 0.80: 6%; p = 0.09 All-cause mortality (at 5 years):…”

Comparison of three-dimensional quantitative coronary angiography and intravascular ultrasound for detecting functionally significant coronary lesions

“…Comparison of three-dimensional quantitative coronary angiography and intravascular ultrasound for detecting functionally significant coronary lesions a wiring procedure and time (3)(4)(5)(6)(7). Three-dimensional quantitative coronary angiography (3D-QCA) derived from routine 2D angiography has been developed and offers a reasonable alternative to FFR or IVUS (8)(9)(10)(11)(12)(13). The purpose of this study was to compare the diagnostic efficacy of 3D-QCA, and IVUS for detecting functionally significant coronary lesions determined by FFR <0.80.…”

“…However, it is difficult to depict true vascular structures of coronary arteries due to limited spatial and temporal resolutions, inability to reflect extraluminal irregularities, lesion asymmetry, and tortuosity. Intracoronary imaging modality like IVUS has been widely used to overcome anatomical pitfalls of visual estimation and 2D-QCA (9,11,12,14). In addition to the anatomical significance obtained by IVUS, FFR may confer additional information of the physiological significance of coronary stenosis.…”

“…3D-QCA has been recently developed to compensate for the limitations of conventional 2D-QCA and allows accurate delineation of true vessel structure by fusion of two angiographic views (8,(12)(13)(14)22). Even though 3D-QCA is derived from incomplete 2D luminography and cannot fully overcome the limitations of 2D-QCA, it may be able to better reflect vessel tortuosity and lesion eccentricity in the assessment of coronary lesions.…”