Value of C-Arm Computed Tomography to Evaluate Stent Deployment During Femoro-Popliteal Revascularization.

Purpose: To compare the accuracy of C-arm computed tomography (CT) and digital subtraction angiography (DSA) in detecting incomplete stent expansion (ISE) after superficial femoral artery (SFA) stenting using intravascular ultrasound (IVUS) as a gold standard.Materials: Fifty patients with symptomat...

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Publicado en:CardioVascular & Interventional Radiology Vol. 38; no. 6; pp. 1458 - 1468
Autores principales: Gahide, Gerald, Hadjadj, Sofiane, Therasse, Eric, Kauffmann, Claude, Gilbert, Patrick, Oliva, Vincent, Tardif, Jean-Claude, Lespérance, Jacques, Cloutier, Guy, Soulez, Gilles, Oliva, Vincent L
Formato: research randomized controlled trial Journal Article
Publicado: Springer Nature Dec2015
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2015
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      pub: Springer Nature
      place: New York, New York
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        atl: Value of C-Arm Computed Tomography to Evaluate Stent Deployment During Femoro-Popliteal Revascularization.
      aug:
        au:
          Gahide, Gerald
          Hadjadj, Sofiane
          Therasse, Eric
          Kauffmann, Claude
          Gilbert, Patrick
          Oliva, Vincent
          Tardif, Jean-Claude
          Lespérance, Jacques
          Cloutier, Guy
          Soulez, Gilles
          Oliva, Vincent L
          Lespérance, Jacques
        affil: Centre de Recherche Etienne LeBel, Centre Hospitalier de l'Université de Sherbrooke, Sherbrooke Canada
      sug:
        subj:
          Radiography, Interventional
          Femoral Artery Radiography
          Arterial Occlusive Diseases Surgery
          Popliteal Artery Radiography
          Tomography, X-Ray Computed Methods
          Stents
          Arterial Occlusive Diseases Radiography
          Femoral Artery Surgery
          Angiography, Digital Subtraction
          Aged
          Prospective Studies
          Femoral Artery Ultrasonography
          Human
          Popliteal Artery Ultrasonography
          Ankle Brachial Index
          Arterial Occlusive Diseases Ultrasonography
          Reproducibility of Results
          Popliteal Artery Surgery
          Female
          Ultrasonography
          Male
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Randomized Controlled Trials
          Funding Source
          Aged: 65+ years
          Female
          Male
      ab: Purpose: To compare the accuracy of C-arm computed tomography (CT) and digital subtraction angiography (DSA) in detecting incomplete stent expansion (ISE) after superficial femoral artery (SFA) stenting using intravascular ultrasound (IVUS) as a gold standard.Materials: Fifty patients with symptomatic SFA occlusive disease requiring angioplasty were prospectively included. Once technical success (<30 % residual stenosis) was obtained on post-procedural DSA, C-arm CT and IVUS were acquired. DSA and C-arm CT examinations were reviewed by 2 investigators and correlated with IVUS. C-arm CT image quality was rated on a four-point scale. Doppler ultrasound was performed at 1-year follow-up.Results: The ankle-brachial index was 0.69 ± 0.10 and 0.99 ± 0.40, respectively, pre- and post-procedure. C-arm CT imaging quality was rated as good or excellent in 80%. In-stent minimal luminal diameter (MLD) was evaluated at 4.71 ± 0.7 mm on DSA, 3.39 ± 0.6 mm on IVUS, and 3.12 ± 0.9 mm on C-arm CT. Compared to IVUS, DSA demonstrated an overestimation of MLD (p = 0.0001), an underestimation of ISE (DSA = 18.8% ± 7.6; IVUS = 29.8% ± 9) (p < 0.0001), and a poor inter-technique intra-class correlation coefficient (ICC = 0.24). No difference was observed between IVUS and C-arm CT in ISE as calculated by diameter (29.8 ± 9 vs. 28.2 ± 12.5%, p = 0.5) and area (30.2 ± 8.4 vs. 33.3 ± 9.5%, p = 0.2). Inter-technique ICC between C-arm CT and IVUS was 0.72 [95%CI 0.49; 0.85] for MLA measurements. The inter-observer ICC for MLD and MLA measurements on C-arm CT were, respectively, estimated at 0.75 [95% CI 0.40, 0.89] and 0.77 [95% CI 0.43, 0.90)].Conclusions: C-arm CT presents a better correlation with IVUS than DSA to determine lumen diameter and ISE immediately after percutaneous revascularization.
      pubtype: Academic Journal
      doctype:
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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