We gathered coronary angiography data obtained at the time of initial percutaneous coronary intervention (PCI) and ST. The view showing the most severe stenosis was selected for quantitative coronary angiography (QCA), which was performed using a computerized angiographic analysis system (QAngioXA 7.3; Medis Medical Imaging Systems, Leiden, the Netherlands) at the same angle of projection before and immediately after PCI.9 Two of the authors (T.T. and N.H.) performed the QCA analysis.
Qangio xa 7
Manufactured by Medis Medical Imaging Systems
Sourced in Macao, Netherlands
QAngio XA 7.3 is a software application for medical image analysis developed by Medis Medical Imaging Systems. It is used for quantitative analysis of coronary angiograms.
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Lab products found in correlation
14 protocols using qangio xa 7
1
Quantitative Coronary Angiography for PCI
2
Angiographic Core Lab Protocol Analysis
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All procedural angiograms were reviewed by an angiographic core laboratory (Saint Luke's Mid America Heart Institute, Kansas City, MO) using QAngio XA 7.3 (Medis Medical Imaging Systems, Leiden, The Netherlands) software. 9
3
Quantitative Coronary Angiography Analysis
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Quantitative coronary angiography (QCA) parameters were measured using a cardiovascular angiography analysis system (QAngio XA 7.3; Medis Medical Imaging Systems, Leiden, Netherlands). QCA parameters were measured after the acquisition of reperfusion (after ballooning or thrombectomy), if the lesion was totally occluded. The definition of lesion characteristics, including lesion length, ostial lesion, bifurcation lesion, tortuosity, and type of obstruction site, has been previously described8
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. The thrombus was classified based on the TIMI thrombus grade21)
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Quantitative coronary angiography (QCA) parameters were measured using a cardiovascular angiography analysis system (QAngio XA 7.3; Medis Medical Imaging Systems, Leiden, Netherlands). QCA parameters were measured after the acquisition of reperfusion (after ballooning or thrombectomy), if the lesion was totally occluded. The definition of lesion characteristics, including lesion length, ostial lesion, bifurcation lesion, tortuosity, and type of obstruction site, has been previously described8
,
18
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20)
. The thrombus was classified based on the TIMI thrombus grade21)
.
4
Quantitative Coronary Angiography for PCI
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For quantitative coronary angiography (QCA), an automated edge-detection algorithm was used; additionally, the offline analysis was performed by examiners who were unaware of the results of the pressure wire examination. Conventional angiograms were assessed using an offline QCA system (QAngio XA 7.3, Medis Medical Imaging Systems, The Netherlands). The reference diameter (RD), minimum lumen diameter (MLD), and lesion length (LL) were measured using an edge-detection system, and the % diameter stenosis (%DS) was subsequently calculated. Notably, angiographic lesions are classified into focal, tandem, and diffuse lesions. Focal lesions were defined as lesions with > 50% stenosis and lengths < 20 mm, tandem lesions based on angiography as 2 separate lesions with > 50% stenosis in the same coronary artery separated by an angiographically normal segment, and diffuse lesions as lesions with significant stenoses of ≥ 20 mm, respectively. Angiographic PCI success was defined as < 30%DS in the presence of thrombolysis in myocardial infarction grade 3.
5
Quantitative Coronary Angiography Analysis
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QVA was performed with QAngio XA 7.3 (Medis Medical Imaging Systems, Leiden, Netherlands) at an independent core laboratory (Stanford Cardiovascular Core Analysis Laboratory, Stanford, CA) that was blinded to procedural details and histological results. The outer diameter of the contrast-filled catheter was used as the calibration standard. Minimum lumen diameter (MLD) was measured from the single worst view. Percent diameter stenosis (%DS) was calculated based on MLD and the interpolated reference vessel diameter.
6
Quantitative Coronary Angiography Protocol
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QCA parameters were measured using the Goodnet Cardiovascular Network system (QAngio XA 7.3; Medis Medical Imaging Systems, Leiden, Netherlands), as described previously.13 (link),14 Values were obtained at 2 time points: before PCI and immediately after successful PCI. Minimum lumen diameter (MLD), %DS, and reference vessel diameter (RD) were measured. For occluded lesions, %DS was defined as 100% and MLD was defined as 0 mm. All QCA parameters were measured using the T.I.
7
Detailed Coronary Angiography Analysis
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Quantitative coronary angiography (QCA) was performed at an independent angiographic core laboratory (Beth Israel Deaconess Medical Center, Boston, USA). Standard QCA variables were obtained with QAngio XA 7.3 (Medis medical imaging systems, Leiden, the Netherlands); the current analysis used in-segment minimum lumen diameter (MLD), DS, and late lumen loss (LLL) defined as absolute changes in MLD from post-procedure to 3 years. To represent more detailed lesion characteristics, calcification, tortuosity and eccentricity were also assessed. Moderate and severe calcification were defined as “densities noted only during the cardiac cycle prior to contrast injection” and “radio-opacities noted without cardiac motion prior to contrast injection generally involving both sides of the arterial wall”, respectively. Moderate and severe tortuosity were defined as “2 bends with >75 degrees or one bend with >90 degrees to reach the target lesion” and “2 bends with >90 degrees to reach target lesion”. Eccentric lesion was defined as a stenosis that had one of its luminal edges in the outer one-quarter of the apparent normal lumen.
8
Refractory Angina Management Protocol
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Refractory angina was defined as baseline angina SAQ AF ≤90 despite ≥3 antianginal medications (β-blockers, calcium channel blockers, long-acting nitrates, and ranolazine). Antianginal medication escalation in follow-up was defined as an additional antianginal agent at hospital discharge or an increase in the dose of a current medication at the time of discharge from the hospital. Technical success was defined as <50% residual stenosis and Thrombolysis in Myocardial Infarction 2 or 3 flow at the conclusion of the procedure and no side branch occlusion. 7 (link) MACCE was defined as in-hospital death, myocardial infarction, emergent cardiac surgery, stroke, or clinical perforation. Clinical perforation was defined as any perforation requiring treatment. 7 (link) All procedural angiograms were reviewed by an angiographic core laboratory (Saint Luke's Mid America Heart Institute, Kansas City, MO) using QAngio XA 7.3 (Medis Medical Imaging Systems, Leiden, The Netherlands) software. 9
9
Underexpanded Stent Deployment Protocol
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Procedural success was defined as the correct RA of the underexpanded stent and the successful delivery of an adequately apposed stent with a residual stenosis <30%.
Major adverse cardiac events (MACE) were defined as the composite of death, myocardial infarction, and target vessel revascularization (TVR) events. Myocardial infarction was defined as recurrent symptoms of ischemia with new re‐elevation of cardiac markers to at least twice the upper limit of normal. TVR was defined as the repeated revascularization of the target vessel. The Academic Research Consortium definition of stent thrombosis was used.19 Quantitative angiography analysis was performed with Q‐Angio XA 7.3 (Medis Medical Imaging systems, Leiden, the Netherlands).
Major adverse cardiac events (MACE) were defined as the composite of death, myocardial infarction, and target vessel revascularization (TVR) events. Myocardial infarction was defined as recurrent symptoms of ischemia with new re‐elevation of cardiac markers to at least twice the upper limit of normal. TVR was defined as the repeated revascularization of the target vessel. The Academic Research Consortium definition of stent thrombosis was used.
10
Quantitative Coronary Angiography Analysis
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Quantitative coronary angiography (QCA) was performed at an angiographic core laboratory (Beth Israel Deaconess Medical Center, Boston, MA, USA), blinded to the MSCT results. The software used was QAngio XA 7.3 (Medis medical imaging systems). Binary restenosis was defined as a diameter stenosis ≥50%.
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