Comparison of angiographic and intravascular ultrasound vessel measurements in infra-popliteal endovascular interventions: The below-the-knee calibration study. Comparison of Angiographic and Intravascular Ultrasound Vessel Measurements in Infra-Popliteal Endovascular Interventions: The Below-the-Knee Calibration Study.

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Citation: Cardiovascular Revascularization Medicine. 35:35-41, 2022 02.PMID: 34544659Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Peripheral Arterial Disease | *Ultrasonography, Interventional | Angiography, Digital Subtraction | Calibration | Humans | Peripheral Arterial Disease/dg [Diagnostic Imaging] | Peripheral Arterial Disease/th [Therapy] | Popliteal Artery/dg [Diagnostic Imaging]Year: 2022ISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: BACKGROUND: Endovascular revascularization (ER) via percutaneous transluminal angioplasty (PTA) and stenting are viable options for revascularization in below-the-knee (BTK) peripheral arterial disease. Two-dimensional angiography has been the standard of practice for estimating vessel size and selecting treatment devices during ER. However, in other vascular territories, intravascular ultrasound (IVUS) offers better visualization of the lumen dimensions.CONCLUSION: Angiography underestimates infrapopliteal reference vessel lumen size even when quantitatively assessed. Adjunctive IVUS imaging use in guiding BTK procedures could help ensure adequate sizing and possibly impact immediate post-procedure indices. Copyright (c) 2021 Elsevier Inc. All rights reserved.METHODS: 20 consecutive patients were enrolled in the BTK Calibration study from 2 sites in the United States and Australia. Patients with at least one diseased segment in a native infra-popliteal artery (below-the-knee) and a clinical indication for endovascular therapy (EVT) were included with no limitations with regards to vessel diameter or lesion length. Digital subtraction angiography and intravascular ultrasound imaging were collected pre-and post-percutaneous transluminal angioplasty and images were sent to an independent Core lab for standardized quantitative analysis of the normal-looking reference vessel dimensions when available. The results were presented as least square means with 95% confidence intervals and a p-value of <0.05 was considered as significant.PURPOSE: To compare angiographic and intravascular ultrasound reference vessel (lumen) measurements in below-the-knee peripheral artery interventions.RESULTS: The overall (N = 19) mean reference vessel diameter for QVA was 2.98 +/- 1.24 vs. 3.47 +/- 0.72 for IVUS (mean difference was -0.50, (95% CI: -0.80, -0.20; p = 0.14). As expected in the proximal segments (N = 12), the mean reference vessel diameters were larger: for QVA was 3.17 +/- 1.34 vs. 3.55 +/- 0.76 in IVUS, (mean difference was -0.38, (95% CI:-0.79,0.03; p = 0.40); while in the distal segments (N = 7), mean reference vessel diameters were smaller: for QVA was 2.64 +/- 1.06 vs. 3.33 +/- 0.67 in IVUS, (mean difference was -0.69, (95% CI:-1.04,-0.34; p = 0.17). We observed a greater degree of acute gain in cases where the treatment balloon size correlated with the IVUS measured reference size.All authors: Adams GL, Beyene SS, DeRubertis BG, Finizio M, Garcia-Garcia HM, Jones-McMeans JM, Kahsay Y, Kuku KO, Melaku GD, Parikh SA, Rapoza RJ, Varcoe RL, Wilson VAOriginally published: Cardiovascular Revascularization Medicine. 2021 Sep 16Fiscal year: FY2022Digital Object Identifier: Date added to catalog: 2021-11-01
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Journal Article MedStar Authors Catalog Article 34544659 Available 34544659

BACKGROUND: Endovascular revascularization (ER) via percutaneous transluminal angioplasty (PTA) and stenting are viable options for revascularization in below-the-knee (BTK) peripheral arterial disease. Two-dimensional angiography has been the standard of practice for estimating vessel size and selecting treatment devices during ER. However, in other vascular territories, intravascular ultrasound (IVUS) offers better visualization of the lumen dimensions.

CONCLUSION: Angiography underestimates infrapopliteal reference vessel lumen size even when quantitatively assessed. Adjunctive IVUS imaging use in guiding BTK procedures could help ensure adequate sizing and possibly impact immediate post-procedure indices. Copyright (c) 2021 Elsevier Inc. All rights reserved.

METHODS: 20 consecutive patients were enrolled in the BTK Calibration study from 2 sites in the United States and Australia. Patients with at least one diseased segment in a native infra-popliteal artery (below-the-knee) and a clinical indication for endovascular therapy (EVT) were included with no limitations with regards to vessel diameter or lesion length. Digital subtraction angiography and intravascular ultrasound imaging were collected pre-and post-percutaneous transluminal angioplasty and images were sent to an independent Core lab for standardized quantitative analysis of the normal-looking reference vessel dimensions when available. The results were presented as least square means with 95% confidence intervals and a p-value of <0.05 was considered as significant.

PURPOSE: To compare angiographic and intravascular ultrasound reference vessel (lumen) measurements in below-the-knee peripheral artery interventions.

RESULTS: The overall (N = 19) mean reference vessel diameter for QVA was 2.98 +/- 1.24 vs. 3.47 +/- 0.72 for IVUS (mean difference was -0.50, (95% CI: -0.80, -0.20; p = 0.14). As expected in the proximal segments (N = 12), the mean reference vessel diameters were larger: for QVA was 3.17 +/- 1.34 vs. 3.55 +/- 0.76 in IVUS, (mean difference was -0.38, (95% CI:-0.79,0.03; p = 0.40); while in the distal segments (N = 7), mean reference vessel diameters were smaller: for QVA was 2.64 +/- 1.06 vs. 3.33 +/- 0.67 in IVUS, (mean difference was -0.69, (95% CI:-1.04,-0.34; p = 0.17). We observed a greater degree of acute gain in cases where the treatment balloon size correlated with the IVUS measured reference size.

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