Summary
The clinical objectives of arteriography are to obtain information that contributes to an understanding of the mechanisms of the clinical syndrome, provides prognostic information, facilitates therapeutic decisions, and guides invasive therapy. Quantitative and improved qualitative assessments of arterial disease provide us with a common descriptive language which has the potential to accomplish these objectives more effectively and thus to improve clinical outcome. In certain situations, this potential has been demonstrated. Clinical investigation using quantitative techniques has definitely contributed to our understanding of disease mechanisms and of atherosclerosis progression/regression. Routine quantitation of clinical images should permit more accurate and repeatable estimates of disease severity and promises to provide useful estimates of coronary flow reserve. But routine clinical QCA awaits more cost- and time-efficient methods and clear proof of a clinical advantage.
Careful inspection of highly magnified, high-resolution arteriographic images reveals morphologic features related to the pathophysiology of the clinical syndrome and to the likelihood of future progression or regression of obstruction. Features that have been found useful include thrombus in its various forms, ulceration and irregularity, eccentricity, flexing and dissection. The description of such high-resolution features should be included among, rather than excluded from, the goals of image processing, since they contribute substantially to the understanding and treatment of the clinical syndrome.
Supported in part by USPHS grants PO1 HL-30086, RO1 HL-19451, HL-18645, and HL-03174, in part by an Established Investigator Award from the American Heart Association (79–116), and in part by a grant from the John L. Locke, Jr. Charitable Trust, Seattle, Washington.
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Brown, B.G., Simpson, P., Dodge, J.T., Bolson, E.L., Dodge, H.T. (1991). Quantitative and qualitative coronary arteriography. In: Reiber, J.H.C., Serruys, P.W. (eds) Quantitative Coronary Arteriography. Developments in Cardiovascular Medicine, vol 117. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-3726-3_1
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