Circulation, Vol 88, 1724-1729, Copyright © 1993 by American Heart Association
A Uehata, T Matsuguchi, JA Bittl, J Orav, IT Meredith, TJ Anderson, AP Selwyn, P Ganz and AC Yeung
BACKGROUND: Quantitative angiography is the accepted method for measuring
coronary luminal diameter. Electronic digital calipers have been used to
assess arterial diameters in vasomotor function studies and after
interventional procedures. However, careful validation of calipers against
quantitative angiography has not been described. METHODS AND RESULTS. We
used digital calipers and quantitative angiography to measure 517 arterial
diameters (88 nonstenotic segments) in 24 transplant patients undergoing
vasomotor function studies with acetylcholine and nitroglycerin, 20
stenoses in 14 patients with coronary artery disease, and 15 stenoses in 15
patients before and after excimer laser-facilitated coronary angioplasty
and at 6 months' follow-up. In nonstenotic arterial segments ranging in
size from 0.6 to 3.5 mm, calipers overestimated diameters measured by
quantitative angiography by 0.29 +/- 0.21 mm (mean +/- SD) (limits of
agreement, - 0.13 to 0.71 mm). However, when the vasomotor responses were
expressed as percent diameter change, the two methods did not differ
significantly (-1 +/- 10%; limits of agreement, -21% to 19%). In the 35
stenoses measured before intervention and 30 stenoses measured after
intervention, calipers and quantitative angiography differed by 3 +/- 9%
(limits of agreement, -15% to 21%) across a range of stenosis severity (11%
to 80%). Repeat caliper measurements by the same observer of the percent
diameter change in the transplant patients and the percent stenosis in the
coronary artery disease patients led to standard deviations of the
differences of 9.3% and 7.6%, respectively. Two different observers
recorded percent diameter change and percent stenosis that differed with
standard deviations of 9.6% and 7.8%, respectively. CONCLUSIONS.
Quantitative angiography and electronic digital calipers produce similar
relative changes in arterial diameters and percent stenosis in a broad
range of severities. Digital calipers thus are a rapid and convenient
alternative to computerized quantitative angiography in certain research
studies and clinical practice of assessing stenosis severity.
ARTICLES
Accuracy of electronic digital calipers compared with quantitative angiography in measuring coronary arterial diameter
Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass.
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