Comparison of definitions of coronary artery reference sizes and effects on stent selection and evaluation of stent expansion

Int J Cardiovasc Imaging. 2023 Sep;39(9):1825-1837. doi: 10.1007/s10554-023-02890-2. Epub 2023 Jul 5.

Abstract

Accurate determination of coronary reference size is essential for optimal stent selection and evaluation of stent expansion during percutaneous coronary intervention (PCI). Several approaches for reference size estimation have been published with no universal agreement. The aim of this study was to investigate if potential differences in coronary reference size estimation lead to differences in stent and balloon selection and in detection of stent under expansion. Definitions for coronary reference size estimation, stent size selection, and stent expansion were identified in 17 randomized controlled trials. The identified methods were applied in a population of 32 clinical cases. Reference size estimates ranged up to 1.35mm, and indicated nominal stent size ranged up to 1.0 mm in the same case depending on method. Mean relative stent expansion ranged from 54±12% to mean 100±29% depending on the applied reference method. Choice of method for reference size estimation using intravascular imaging may influence stent selection and greatly affects evaluation of post-PCI stent expansion.

Keywords: Coronary reference estimations; Intervascular imaging; Optical coherence tomography; Stent expansion.

Publication types

  • Comparative Study

MeSH terms

  • Coronary Angiography / methods
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / therapy
  • Coronary Vessels / diagnostic imaging
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / methods
  • Predictive Value of Tests
  • Stents
  • Tomography, Optical Coherence / methods
  • Treatment Outcome