Accuracy and rate of coronary artery segment visualization with CT angiography for the non-invasive detection of coronary artery stenoses

Abstract Objectives To evaluate computed tomography fractional flow reserve (FFRCT) values in distal parts of the coronaries in an asymptomatic cohort of marathon runners without any coronary stenosis for potentially false-positive values. Methods Ninety-eight asymptomatic male marathon runners (age 53 ± 7 years) were enrolled in a prospective monocentric study and underwent coronary computed tomography angiography (CCTA). CCTA data were analyzed for visual coronary artery stenosis. FFRCT was evaluated in 59 participants without coronary artery stenosis in proximal, mid, and distal coronary sections using an on-site software prototype. Results In participants without coronary artery stenosis, abnormal FFRCT values ≤ 0.8 in distal segments were found in 22 participants (37%); in 19 participants in the LAD; in 5 participants in the LCX; and in 4 participants in the RCA. Vessel diameters in participants with FFRCT values > 0.80 compared to ≤ 0.80 were 1.6 ± 0.3 mm versus 1.5 ± 0.3 mm for distal LAD (p = 0.025), 1.8 ± 0.3 mm versus 1.6 ± 0.5 mm for distal LCX (p = 0.183), and 2.0 ± 0.4 mm versus 1.5 ± 0.2 mm for distal RCA (p < 0.001). Conclusions Abnormal FFRCT values of ≤ 0.8 frequently occurred in distal coronary segments in subjects without any anatomical coronary artery stenosis. This effect is only to some degree explainable by small distal vessel diameters. Therefore, the validity of hemodynamic relevance evaluation using FFRCT in distal coronary artery segment stenosis is reduced. Key Points • Abnormal FFRCT values (≤ 0.8) occurred in over a third of the subjects in the distal LAD despite the absence of coronary artery stenosis.. • Therefore, the validity of hemodynamic relevance evaluation in distal coronary artery segment stenosis is reduced. • Decision-making based on abnormal FFRCT values in distal vessel sections should be performed with caution and only in combination with visual assessment of the grade of stenosis..

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Abstract 915: The Effect of Gender and Race on Outcomes in Patients Undergoing PCI for Proximal Coronary Artery Lesions: A Report from the NHLBI Dynamic Registry of PCI

Circulation ◽

10.1161/circ.118.suppl_18.s_632 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Sandy M Green ◽

Faith Selzer ◽

Suresh Mulukutla ◽

Ashley Lee ◽

Lee S Joon ◽

...

Keyword(s):

Coronary Artery ◽

Female Gender ◽

Adverse Outcomes ◽

High Risk Population ◽

Gender And Race ◽

Repeat Revascularization ◽

Coronary Artery Segment ◽

Artery Segment ◽

Coronary Lesions ◽

Proximal Coronary Artery

Background: Little is known about the effect of gender and race on outcomes in patients after revascularization of proximal coronary lesions (PCL). We investigated their effect on outcomes using the NHLBI Dynamic Registry. Methods: Of the 9962 patients receiving PCI, 3918 (39%) were treated for disease in a proximal coronary artery segment. Left main and PCI for graft lesions were excluded. Primary outcomes were death/MI or need for repeat revascularization at 1 year after the index procedure. Results: 80% of the patients were white (n=3144), 11% black (n=469), 63% male (n=2461), and 37% female (n=1457). Patients with PCL had lower rates of HTN, prior MI, but where older and had more concomitant medical disease. Compared to non-proximal lesions, patients with PCL had higher rate of death (5.4% vs. 4%, p=0.001) and repeat revascularization (16.3% vs. 14.3%, p=0.01). The effect of gender and race were then included in the multivariate model for predicting risk in patients with PCL (Table 1 ). Race did not modify the risk associated with PCL but females had a 32% greater relative risk (p=0.002) of repeat revascularization when compared to men. Conclusions: Treatment of proximal coronary lesions is associated with a more adverse outcomes compared to non-proximal coronary lesions. In this high-risk population, female gender is an independent predictor for the need for repeat revascularization. Table 1: Event rates, unadjusted and adjusted hazard ratios and 95% confidence intervals in patients undergoing proximal vessel PCI

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126: Atherosclerotic Plaque Composition Among Patients with Stenotic Coronary Artery Disease on Non Invasive CT Angiography

Journal of Cardiovascular Computed Tomography ◽

10.1016/j.jcct.2008.06.151 ◽

2008 ◽

Vol 2 (4) ◽

pp. S44-S45

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Ct Angiography ◽

Atherosclerotic Plaque ◽

Plaque Composition ◽

Non Invasive ◽

Artery Disease

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Detection of Coronary Artery Stenoses by Low-Dose, Prospectively ECG-Triggered, High-Pitch Spiral Coronary CT Angiography

JACC Cardiovascular Imaging ◽

10.1016/j.jcmg.2011.01.012 ◽

2011 ◽

Vol 4 (4) ◽

pp. 328-337 ◽

Cited By ~ 124

Author(s):

Stephan Achenbach ◽

Tobias Goroll ◽

Martin Seltmann ◽

Tobias Pflederer ◽

Katharina Anders ◽

...

Keyword(s):

Coronary Artery ◽

Ct Angiography ◽

Coronary Ct Angiography ◽

Low Dose ◽

High Pitch ◽

Coronary Ct ◽

Coronary Artery Stenoses

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Non-invasive assessment of functionally relevant coronary artery stenoses with quantitative CT perfusion: preliminary clinical experiences

European Radiology ◽

10.1007/s00330-011-2260-x ◽

2011 ◽

Vol 22 (1) ◽

pp. 39-50 ◽

Cited By ~ 51

Author(s):

Aaron So ◽

Gerald Wisenberg ◽

Ali Islam ◽

Justin Amann ◽

Walter Romano ◽

...

Keyword(s):

Coronary Artery ◽

Ct Perfusion ◽

Clinical Experiences ◽

Quantitative Ct ◽

Non Invasive ◽

Coronary Artery Stenoses

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Stenosis Detection Algorithm for Coronary Angiograms

International Journal of Innovative Technology and Exploring Engineering - Special Issue ◽

10.35940/ijitee.i8743.078919 ◽

2019 ◽

Vol 8 (9) ◽

pp. 2362-2367

Keyword(s):

Coronary Artery ◽

Coronary Vessels ◽

Ground Truth ◽

Detection Algorithm ◽

Vital Role ◽

Coronary Artery Segment ◽

Blob Analysis ◽

Artery Segment ◽

Stenosis Detection ◽

Background Image

Automatic detection of blocks in the angiographic images is a challenging task. The features such as contrast and gradient of the vessels and the background image are playing a vital role in the detection of the blocks in the X-Ray angiograms. Nowadays, doctors manually identify blocks in the coronary vessels. The automation tool is necessary to identify the blocks in the blood vessels of the heart to help the doctors in the diagnosing process. Spatiotemporal nature of the angiography sequences is used to isolate the coronary artery tree. The coronary artery segment is tracked and in each image frame by frame and the arterial width surface is detected. The stenosis identification is done by using coronary vessel surface’s persistent minima and blob analysis. The proposed method is experimented on 42 patients’ dataset. The performance of the proposed method was evaluated by comparing the blocks identified by the algorithm with the hand-labelled ground truth images given by the experts. The proposed method provides an accuracy of 95.5% on 42 patients with a total of 60 image runs.

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