Skip to main content
Log in

Validation of coronary artery saphenous vein bypass graft diameter measurements using quantitative angiography

  • Articles
  • Published:
The International Journal of Cardiac Imaging Aims and scope Submit manuscript

Abstract

The accepted value for reproducibility (true change) is two standard deviations (SD) of the differences between repeat measurements. It has been well established for coronary artery measurements using several different quantitative coronary angiography (QCA) systems, but it has not been well documented for saphenous vein grafts (SVG). The purpose of this study was to assess, using the Cardiovascular Measurement System (CMS), the measurement reproducibility of 24 vein grafts from 24 patients who had symptom-directed control angiography. Three equal graft segments were studied separately. Focal narrowings expressed in percent stenosis varied from 5 to 80% (mean 20.8±15.9%). The average minimum lumen diameter (MLD) was 3.07±0.81 mm and the average interpolated reference diameter (Ref.D) was 3.87±0.58 mm. We assessed the reproducibility of measurements obtained from two separate imagings of the graft in the same view but at least 20 minutes apart, near the beginning and at the end of the angiographic procedure (simulating baseline and end-trial examinations). The SD for differences in measurements (variability) was 0.183 mm for the MLD, 0.193 mm for the Ref.D, 0.184 mm for the mean diameter (Mean D) and 3.72% for the percent diameter stenosis (PDS).

A reasonable true change cut-off for SVG measurements in our laboratory is ≥ 0.4 mm for the minimum and mean lumen diameters, and ≥ 10% for the PDS, when QCA is obtained with the QCA-CMS analytical software package.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Reiber JHC, Serruys PW, Kooijman CJ, Wijns W, Slager CJ, Gerbrands JJ, Schuurbiers JCH, den Boer A, Hugenholtz PG. Assessment of short-, medium-, and long-term variations in arterial dimensions from computer-assisted quantitation of coronary cineangiograms. Circulation 1985; 71: 280–288.

    Google Scholar 

  2. Brown BG, Bolson EL, Dodge HT. Quantitative computer techniques for analyzing coronary arteriograms. Prog Cardiovasc Dis 1986; 6: 403–418.

    Google Scholar 

  3. Waters D, Lespérance J, Craven TE, Hudon G, Gillam LD. Advantages and limitations of serial coronary arteriography for the assessment of progression and regression of coronary atherosclerosis: Implications for clinical trials. Circulation 1993; 87 (Suppl II): II-38–47.

    Google Scholar 

  4. Lichtlen PR, Hugenholtz PG, Rafflenbeul W, Hecker H, Jost S, Deckers JW on behalf of the INTACT group investigators. Retardation of angiographic progression of coronary artery disease by nifedipine. Lancet 1990; 335: 1109–1113.

    Google Scholar 

  5. Waters D, Higginson L, Gladstone P, Kimball B, Le May M, Boccuzzi SJ, Lespérance J, the CCAIT study group. Effects of monotherapy with an HMG-CoA reductase inhibitor on the progression of coronary atherosclerosis as assessed by serial quantitative arteriography. The Canadian Coronary Atherosclerosis Intervention Trial. Circulation 1994; 89: 959–968.

    Google Scholar 

  6. Jukema JW, Bruschke AVG, van Boven AJ, Reiber JHC, Bal ET, Zwinderman AH, Jansen H, Boerma GJM, van Rappard FM, Lie KI, on behalf of the REGRESS study group. Effects of lipid lowering by pravastatin on progression and regression of coronary artery disease in symptomatic men with normal to moderately elevated serum cholesterol levels. The Regression Growth Evaluation Statin Study (REGRESS). Circulation 1995; 91: 2528–2540.

    Google Scholar 

  7. Blankenhorn DH, Selzer RH, Mack WJ, Crawford DW, Pogoda J, Lee PL, Shircore AM, Azen SP. Evaluation of colestipol/niacin therapy with computer-derived coronary end point measures. A comparison of different measures of treatment effect. Circulation 1992; 86: 1701–1709.

    Google Scholar 

  8. Campeau L, Knatterud G, White C, Domanski M, Geller NL, Rosenberg Y, and the Post-CABG Clinical Trial Investigators. The NHLBI Post-Coronary Artery Bypass Graft Clinical Trial (POST-CABG): Angiographic outcomes in developments, lipid -lowering therapy and progression of coronary atherosclerosis. In: Bruschke AVG, Reiber JHC, Lie KI, Wellens HJJ, (eds). Kluwer Academic Publishers: Dordrecht/Boston/London, 1996: 203–214.

    Google Scholar 

  9. Syvänne M, Nieminen MS, Frick MH. Accuracy and precision of quantitative arteriography in the evaluation of coronary artery disease after coronary bypass surgery. Inter J Cardiac Imaging 1994; 10: 243–252.

    Google Scholar 

  10. Reiber JHC, van der Zwet PMJ, von Land CD, Koning G, van Meurs B, Buis B, van Voorthuisen AE. Quantitative coronary arteriography: Equipment and technical requirements. In: Reiber JHC, Serruys PW, (eds). Advances in quantitative coronary arteriography, Dordrecht: Kluwer Academic Publishers, 1993: 75–111.

    Google Scholar 

  11. Lespérance J, Waters D. Measuring progression and regression of coronary atherosclerosis in clinical trials: problems and progress. Int J Cardiac Imaging 1992; 8: 165–173.

    Google Scholar 

  12. Reiber JHC, Koning G, von Land CD, van der Zwet PMJ. Why and how should QCA systems be validated? In: Reiber JHC, Serruys PW, (eds). Progress in Quantitative Coronary Arteriography. Kluwer Academic Publishers, 1994: 33–48.

  13. Lespérance J, Campeau L, Laurier J, Bois M, Dyrda I, Bilodeau L, Doucet S, Hudon G. Reproducibility (true change) of coronary artery saphenous vein graft measurements using quantitative angiography. (abstract) Atherosclerosis X 1994; 109: 298.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lespérance, J., Campeau, L., Reiber, J.H.C. et al. Validation of coronary artery saphenous vein bypass graft diameter measurements using quantitative angiography. Int J Cardiac Imag 12, 299–303 (1996). https://doi.org/10.1007/BF01797743

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01797743

Key words

Navigation