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

Guimarães, Jorge Augusto Nunes; Victor, Edgar Guimarães; Leite, Maria do Rosário de Britto; Gomes, José Maria Pereira; Filho, Edgar Victor; Liveras, Jesus Reyes

doi:10.1590/s0066-782x2000000400001

Cited by 4 publications

(4 citation statements)

References 31 publications

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“…However, angiography can only be used to evaluate therapeutic effects based on vascular morphology and does not truly represent microcirculatory perfusion of ischemic limb tissues. Angiography also requires a simple subjective visual interpretation, which leads to operator-dependent evaluation of endovascular intervention and significant intra/inter-observer variation [ 4 , 5 ]. Thus, the lack of volumetric characterization and quantitative accuracy of angiography presents challenges in determining success of revascularization.…”

Section: Introductionmentioning

confidence: 99%

2D perfusion angiography: an alternative method to evaluate endovascular intervention for acute lower limb ischemia

You

Zhang

et al. 2022

BMC Cardiovasc Disord

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Background Despite advances in endovascular techniques to treat acute limb ischemia (ALI), evaluation of clinical outcomes for revascularization remains challenging, especially the accurate quantification of post-endovascular limb perfusion. This study aimed to investigate the accuracy and value of 2D perfusion angiography to evaluate endovascular intervention for ALI. Methods A total of 47 patients with ALI were retrospectively analyzed. The transcutaneous oxygen partial pressure (TcPO2) was obtained using laser Doppler blood perfusion monitoring. The ankle-brachial index (ABI) and angiographic images were obtained before and after endovascular intervention. iFlow imaging was used to obtain color-coded images. Regions of interest (ROIs) at the femoral head, knee joint, and ankle joint were selected to obtain the time to peak (TTP). The differences in the TTP between the knee and femoral head regions (TTP difference in the knee area) and between the ankle and knee regions (TTP difference in the ankle area) were observed. The TTP, ABI, and TcPO2 between the complete response (CR), partial response (PR), no response (NR), and amputation (AM) groups were compared. The correlation between TTP changes in the ankle area (ΔTTP) and changes in ABI (ΔABI)/changes in TcPO2 (ΔTcPO2) was analyzed. Results There was a significant increase in both TcPO2 and ABI compared with the pre-intervention values (27.75 ± 5.32 vs 40.92 ± 4.62, and 0.35 ± 0.16 vs 0.79 ± 0.15, respectively, all p < 0.01). The post-intervention TTP differences in the knee areas (5.12 ± 2.45 s) and ankle areas (6.93 ± 4.37 s) were significantly faster than pre-intervention TTP differences (7.03 ± 2.57 s and 10.66 ± 4.07 s, respectively, all p < 0.05). The post-operative TTP in the ankle area, post-operative TTP difference in the ankle area, and ΔTTP in the AM group were higher than the values in the CR and PR groups. The ΔTTP demonstrated strong correlation with ΔABI (r = −0.722, p < 0.01) and ΔTcPO2 (r = −0.734, p < 0.01). Conclusions 2D perfusion angiography with enhanced visual and quantitative analysis exhibits great potential to evaluate the efficacy of endovascular intervention, and provides a quantitative and sensitive tool to evaluate post-endovascular limb perfusion for ALI patients.

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Section: Introductionmentioning

confidence: 99%

2D perfusion angiography: an alternative method to evaluate endovascular intervention for acute lower limb ischemia

You

Zhang

et al. 2022

BMC Cardiovasc Disord

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“…As a result, the assessment of the success of revascularisation can be operator dependent and qualitative in nature. Several studies, although not conducted exclusively for lower extremity DSA, have shown that simple visual interpretation of angiography is associated with significant intra- and inter-observer variability 13, 14. Simple visual analysis of DSA images has been a widely adopted and established method of haemodynamic assessment since its advent, but the lack of quantitative and volumetric characterisation limits its accuracy in modern day vascular practise.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Flow after Lower Extremity Endovascular Revascularisation: A Feasibility Study Using Time Attenuation Curve Analysis of Digital Subtraction Angiography

Papadimas

Dharmaraj

2019

EJVES Short Reports

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ObjectivesEndovascular revascularisation is the mainstay of the treatment of lower extremity peripheral arterial disease. Improvement in perfusion after treatment is often quantified by a corresponding increment in ankle or toe brachial indices. These measurements are difficult to obtain in patients with foot wounds, and have to be performed at a separate time and setting after revascularisation. This preliminary study aimed to evaluate the use of parametric colour coding and analysis of time attenuation curves as a real time quantitative measure of perfusion after endovascular revascularisation.MethodsForty-seven consecutive patients with critical limb ischaemia were retrospectively enrolled and analysed. Parametric colour coding and generation of time attenuation curves in the main pedal vessel was performed for pre- and post-intervention digital subtraction angiograms of each patient. The change in time attenuation curve parameters was compared with the change in ankle or toe brachial indices before and after intervention.ResultsComparing before and after lower extremity endovascular intervention, there were significant changes in the washout parameters derived from the time attenuation curve. The percentage of contrast decay 4 seconds after peak (I4s) demonstrated the strongest correlation (R = .482) with the change in ankle or toe brachial indices.ConclusionsParametric colour coding and time attenuation curve analysis might be a helpful tool that can provide real time intra-procedural quantitative data on pedal perfusion which can improve clinical outcomes.

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“…When we performed a search in the literature for evaluation of agreements with CA, although the anatomical reference standard is used, we found a great variation, with Kappa ranging from 36 to 63 for detailed dichotomous measures on the degree of lesion (0.1 -50.51 -69 and >70) and Kappa of 37 to 82 for less detailed dichotomous measures (>70 or >70) 12 .…”

Section: Discussionmentioning

confidence: 99%

Software livre e de código aberto para avaliação de imagens de angiotomografia de coronárias

Hadlich¹,

Oliveira²,

Feijóo³

et al. 2012

Arq. Bras. Cardiol.

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Background: The standardization of images used in Medicine in 1993 was performed using the DICOM (Digital Imaging and Communications in Medicine) standard. Several tests use this standard and it is increasingly necessary to design software applications capable of handling this type of image; however, these software applications are not usually free and open-source, and this fact hinders their adjustment to most diverse interests.

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

Abstract: Objective -Evaluation of inter and intraobserver reproducibility of by the visual method interpretation of cineangiogram in a clinically based context. Methods -

Cited by 4 publications

References 31 publications

2D perfusion angiography: an alternative method to evaluate endovascular intervention for acute lower limb ischemia

2D perfusion angiography: an alternative method to evaluate endovascular intervention for acute lower limb ischemia

Assessment of Flow after Lower Extremity Endovascular Revascularisation: A Feasibility Study Using Time Attenuation Curve Analysis of Digital Subtraction Angiography

Software livre e de código aberto para avaliação de imagens de angiotomografia de coronárias

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