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The QCA-CMS is a medical imaging system designed for quantitative coronary angiography (QCA). It provides precise measurements of coronary artery dimensions and parameters.

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5 protocols using qca cms

1

Quantitative Coronary Angiographic Analysis

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Quantitative coronary angiographic analysis was performed using QCA-CMS (Medis Medical Imaging Systems, Leiden, The Netherlands). All angiograms were analyzed in a random sequence by 2 experienced observers who were blinded to the clinical characteristics of patients. Coronary angiograms were obtained in multiple views after intracoronary nitrate administration. Reference diameter, minimal lumen diameter, percentage diameter stenosis, and lesion length were measured before and after intervention and at followup. Acute gain was defined as minimal lumen diameter immediately after the procedure minus that at baseline. Late lumen loss was defined as minimal lumen diameter immediately after the procedure minus that at angiographic follow-up. Delayed late lumen loss was defined as minimal lumen diameter at early follow-up minus that at late follow-up. Measurements were done at the target lesion treated by DES implantation within 5 mm proximal and distal to the treated area. In-stent restenosis was classified according to the Mehran classification. 8 A multifocal lesion was classified as nonfocal-type restenosis lesion. Stent fracture was angiographically defined at the use of a repeat DES.
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2

Quantitative Coronary Angiography Evaluation

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Quantitative coronary angiography was performed using QCA-CMS (Medis medical imaging systems, Leiden, The Netherlands). Minimum lumen diameter, reference diameter, and lesion length were measured in diastolic frames from orthogonal projections. Angiographic calcification was classified as none or mild, moderate, or severe at the target lesion site [7 ]. Moderate calcification was defined as radio-opacities noted only during the cardiac cycle before contrast injection, whereas severe calcification was defined as radio-opacities seen without cardiac motion, usually affecting both sides of the arterial lumen. Maximum coronary artery angle was defined as the maximum angiographic angle using the view with maximum angle [4 ].
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3

Quantitative Coronary Angiography for PCB and Stent

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Serial coronary angiography was performed at baseline (before and after the intervention) and at six-to eight-month followup. Quantitative coronary angiographic analysis was performed using QCA-CMS (Medis Medical Imaging Systems, Leiden, The Netherlands). Reference diameter, minimal lumen diameter, percentage diameter stenosis, and lesion length were measured before and after the intervention, and at follow-up. Acute gain was defined as minimal lumen diameter immediately after the procedure minus that at baseline. Late lumen loss was defined as minimal lumen diameter immediately after the procedure minus that at angiographic follow-up. Measurements were carried out at the target lesion treated by PCB or stent within 5 mm proximal and distal to the treated area. ISR was classified according to the Mehran classification 7 . Multifocal, diffuse, proliferative, and occlusive lesions were classified as nonfocal type restenosis lesions. Stent fracture was angiographically defined at the time of use of the PCB or repeat DES.
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4

Quantitative Coronary Angiography Analysis

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Quantitative coronary angiography (QCA) analysis was performed using QCA-CMS (Medis Medical Imaging Systems, Leiden, The Netherlands). Coronary angiograms were obtained in multiple views after intracoronary nitrate administration. Reference diameter, minimal lumen diameter, percentage diameter stenosis, and lesion length were measured before and after the procedure and at follow-up. SF was defined as the complete separation of stent seg- symptoms or objective signs of ischemia (at rest, or on stress ECG or myocardial perfusion imaging). Even in the absence of clinical or functional ischemia, TLR was considered as clinically indicated if the lesion diameter stenosis was ≥70% by QCA. Events related to non-EES-implanted lesions were not included in the evaluation of ST and TLR.
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5

Adverse Cardiac Events in Stent Implantation

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The primary outcome of this the study was major adverse cardiac events (MACE) defined as the composite of cardiac death, recurrent MI, TLR, TVR, and ST.
Follow-up angiographic results of the target lesions were also evaluated. ST was diagnosed according to the Academic Research Consortium definition using the definite or confirmed and probable categories [19] . TLR was defined as undergoing PCI or bypass surgery to treat restenosis of the target lesions that were associated with recurrent angina and/or evidence of myocardial ischemia. Quantitative coronary angiography (QCA) of target lesions was performed by a single operator who was blinded to the type of stent implanted. Reference diameter (RD), lesion length (LL), minimum lumen diameter (MLD), and percent diameter stenosis (%DS) were calculated by a QCA analyzer (QCA-CMS; Medis Medical Imaging Systems, Leiden, the Netherlands) pre-PCI, post-PCI, and at follow-up angiography.
Finally, we performed univariate and multivariate analyses to determine predictive risks for primary endpoint (MACE).
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