Assessment of stenoses in coronary angioplasty. Inter- and intraobserver variability

Meier, Bernhard; Gruentzig, Andreas R.; Goebel, N; Pyle, Roger; Gosslar, Wolfgang von; Schlumpf, M

doi:10.1016/0167-5273(83)90032-3

Cited by 86 publications

(17 citation statements)

References 15 publications

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“…The final diameter stenosis was expressed as the mean of measurements in multiple projections by experienced observers without knowledge of the scintigraphic findings using the method of Meier et al 29 Vessels with stenoses of 45% or greater or with sequential subcritical lesions of greater than 30% but less than 50% were also identified for separate analysis.…”

Section: Methodsmentioning

confidence: 99%

Quantitative rotational thallium-201 tomography for identifying and localizing coronary artery disease.

et al. 1988

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The purpose of this study was to develop and validate a method for quantifying the uptake, redistribution, and washout of thallium-201 (201T1) obtained with rotational tomography. This method generates maximum count circumferential profiles of the short-axis slices of the left ventricle, translates them into polar coordinate profiles, and displays them as a bullseye plot, which consists of a series of concentric circles with the apex at the center and the base at the periphery. Normal limits were established for the distribution of°0T1 in 36 patients with a low (<5%) probability of coronary artery disease (CAD). Forty-five patients who had undergone coronary angiography were used as a pilot group to define criteria for the identification and localization of perfusion defects. The best agreement with the results of angiography was found when abnormal regions of the bullseye were defined as contiguous defects over 2.5 SDs below normal. These criteria were applied prospectively to 210 points (179 points with >50% diameter stenosis and 31 with <50%). Visual, quantitative, and combined visual and quantitative analysis were compared for overall detection of disease and for detection of individual vessel involvement. The overall sensitivity for detection of disease by these methods was 97%, 95%, and 95%, respectively. The specificities were 68%, 74%, and 71% respectively. The sensitivity for detection of individual vessel involvement with the bullseye alone was 78% for the left anterior descending artery (LAD), 89% for the right coronary artery (RCA), and 65% for the left circumflex (LCx). For visual analysis, the results were 70%, 88%, and 50%, respectively, while the use of visual and quantitative analysis combined identified 75% of LAD, 87% of RCA, and 55%

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Section: Methodsmentioning

confidence: 99%

Quantitative rotational thallium-201 tomography for identifying and localizing coronary artery disease.

et al. 1988

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“…Our results are similar to those observed in other studies 9,11,22,34 , however their objective and design were much different so hampering the determination of a suitable pattern for estimating the precision of the method employed. Under the impact of the appearance of coronary angioplasty, several studies proposing to enhance reliability of the interpretation of CCG have been published [10][11][12][13][15][16][17][18] . Technological developments led to improvement in quantitative digital analysis methodology and evolution of their indexes of reproducibility 14,27,35,36 .…”

Section: Discussionmentioning

confidence: 99%

“…The large margin of variability, especially for results expressed in terms of percent values, has become evident. Although some authors [10][11][12][13] have suggested alternative approaches aimed at increasing the precision of visual estimates, application of quantitative digital analysis has become a standard in scientific literature [13][14][15][16][17][18] . Yet, the use of this method in clinical practice is not automatic.…”

mentioning

confidence: 99%

Reliability of the interpretation of coronary angiography by the simple visual method

Guimarães¹,

Victor²,

Leite³

et al. 2000

Arq. Bras. Cardiol.

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“…Meier and coworkers [12] assessed PTCA results by visual observation and by measuring the diameter of the stenotic and normal lumens with a calibrated magnifying glass. Based on changes in diameter, stenosis before PTCA averaged 73 % and following PTCA was 36%.…”

Section: Visual Estimationmentioning

confidence: 99%

Estimation of the effects of angioplasty on coronary stenosis using quantitative video angiography

Bové

Holmes²,

Owen³

et al. 1985

Cathet. Cardiovasc. Diagn.

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In this study, we compared stenosis severity by quantitative coronary angiography from video and cine images with visual estimation in 14 patients who underwent PTCA. Both cine and video analysis demonstrated a change from 65.2 +/- 2.5 to 36.5 +/- 3.1% diameter stenosis following PTCA, whereas visual estimation (average of three observers) showed improvement from 89.9 +/- 1.7 to 36.0 +/- 3.2%. Percent area stenosis from quantitative angiography showed improvement from 87.9 +/- 1.8 to 56.4 +/- 5.8. These data indicate that visual assessment overestimated percent diameter of severe lesions. To determine if video analysis could provide rapid quantitative assessment of PTCA results, we compared percent diameter and percent area stenosis by video with cine (diameter: correlation coefficient, 0.82; slope, 0.79; area: correlation coefficient, 0.86; slope, 0.83). These results indicate that video-based measurements are not different from cine-derived measurements. Quantitative coronary angiography provides an accurate estimate of changes produced by PTCA and can be performed rapidly and accurately on video images, thus making results available during the PTCA procedure.

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Assessment of stenoses in coronary angioplasty. Inter- and intraobserver variability

Cited by 86 publications

References 15 publications

Quantitative rotational thallium-201 tomography for identifying and localizing coronary artery disease.

Quantitative rotational thallium-201 tomography for identifying and localizing coronary artery disease.

Reliability of the interpretation of coronary angiography by the simple visual method

Estimation of the effects of angioplasty on coronary stenosis using quantitative video angiography

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