Quantitative coronary analysis and visual estimation of Balloon size; incidence of coronary artery dissection

Original article


Naserdeen Mehana1, Tysir Garadah2, Abdulla Al Naeemi1

1) Sheikh Zayed Hospital, Abu Dhabi, UAE; 2) Tabouk Military Hospital KSA

JMJ Vol. 4, No. 1 (Summer 2005): 49-51


Intimal dissection is a complication of coronary angioplasty (PTCA). Balloon over sizing increases this complication. Forty patients were prospectively randomized for visual estimation of reference diameter or by quantitative angiography (QCA). The dilatation balloon diameter was selected according to the estimated coronary segment reference diameter. The aim of the study is to test if the balloon sizing using the QCA will reduce coronary dissection. The mean age was 53.9 +/- 2 years in the QCA group and 54.9 +/- 2 years in the visual group. The pre PTCA reference diameter was 2.718 +/- 0.1326 in the visual group and 2.6256 +/- 0.14451 in the QCA group. The post PTCA mean reference diameter was 3.1 +/- 1.4 mm in the QCA group and 3.02 +/- 1.3 mm in the visually estimated group. Five patients complicated by dissection and abrupt closure. In the visual group three patients needed bailout stenting and one patient needed perfusion balloon. One patient in the QCA group needed cornary artery (by pass) surgery (p=0.437). The balloon to artery ratio was 0.99 +/- 0.02 in the QCA group and 1.2 +/- 0.06 in the visual group (p= 0.0031). We concluded that the QCA estimation of balloon size can decrease coronary dissection and related complications.

Keywords: quantitative coronary analysis, percutaneous coronary angioplasty, dissection, coronary stenting, visual estimation

Link/DOI: http://www.jmj.org.ly/modules.php?name=News&file=article&sid=10