Comparison of coronary vessel sizing using coronary angiography versus intravascular ultrasound in Egyptian patients

Background: Coronary artery disease (CAD) is a leading causeof death worldwide. Intravascular imaging is an important toolin the arsenal of each interventional cardiologist. While angiographyprovides a two-dimensional image of a three-dimensionalstructure, intravascular imaging enhances understanding by providingdetailed cross-sectional images. This study aimed to investigatethe discrepancies in coronary vessel sizing between quantitativecoronary angiography (QCA) and intravascular ultrasound.Methods: This cohort study was conducted on 69 patients whowere referred for elective coronary angiography. Patients weresubjected to history taking, examination, blood samples, electrocardiogram(E.C.G.), and echocardiography. Then, a comparisonof each vessel’s luminal diameter by QCA and IVUS was done.Results: The study included 69 patients; The mean age was 54.7± 9.7. There was a statistically significant difference between thestudied vessels regarding the discrepancy between luminal diametersmeasured by IVUS and QCA. IVUS luminal diameter waslarger than QCA luminal diameter (the median difference in measuresof QCA and IVUS in the left main artery, LAD, LCX, and RCAwere -0.8, -0.55, -0.4, and -0.5 respectively). Furthermore, thereis a statistically significant difference between the studied vesselsregarding the presence of a difference >0.75 mm between theluminal diameters measured by IVUS and QCA (Difference >0.75mm in the left main artery, LAD, left circumflex and RCA were55.8%, 21.7%, 30.8%, and 15.4% respectively). Conclusion: Coronarylesions were underestimated by QCA in comparison to IVUSregarding luminal diameter, especially the left main (LM).