Accuracy of quantitative vessel analysis in endovascular treatment for femoropopliteal lesions

Shinsuke Mori; Keisuke Hirano; Mitsuyoshi Takahara; Shigemitsu Shirai; Kenji Makino; Yohsuke Honda; Masakazu Tsutsumi; Norihiro Kobayashi; Masahiro Yamawaki; Yoshiaki Ito

doi:10.21037/qims-20-1097

Accuracy of quantitative vessel analysis in endovascular treatment for femoropopliteal lesions

Quant Imaging Med Surg. 2022 Jan;12(1):568-575. doi: 10.21037/qims-20-1097.

Affiliations

¹ Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan.
² Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.
³ Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan.

Abstract

Background: Our aim was to evaluate the accuracy of quantitative vessel analysis (QVA) in measuring the reference vessel diameter (RVD) of femoropopliteal lesions.

Methods: Between October 2014 and September 2015, 30 consecutive femoropopliteal lesions in 25 patients who underwent endovascular therapy (EVT) under intravascular ultrasound (IVUS) guidance were analyzed. RVDs measured using QVA_sheath (calibrated using a 6-Fr sheath in the common femoral artery) and QVA_ruler (calibrated using a ruler on the angiography table) were compared to those obtained using IVUS as the reference values.

Results: The mean QVA_sheath-measured RVD was significantly larger than the mean IVUS-measured RVD (5.34±1.29 vs. 5.07±1.20 mm, P=0.001). In contrast, mean QVA_ruler-measured RVD was 4.60±1.04 mm, which was significantly smaller than both the mean IVUS- and mean QVA_sheath-measured RVD (both P<0.001). Bland-Altman analysis revealed that the 95% limits of agreement versus IVUS ranged from -0.94 to 1.49 mm for QVA_sheath and -1.69 to 0.76 mm for QVA_ruler, respectively. Agreement with tolerance of ±1.00 mm accounted for 88% of QVA_sheath and 83% of QVA_ruler (P=0.60). The difference between QVA- and IVUS-measured RVDs was inversely correlated with the distance from the table (P=0.029 for QVA_sheath and P=0.003 for QVA_ruler).

Conclusions: The accuracy of both QVA_sheath and QVA_ruler in measuring RVD were similarly suboptimal. Over- and under-estimation of RVD is not rare in QVA.

Keywords: Quantitative vessel analysis (QVA); accuracy; endovascular therapy (EVT); intravascular ultrasound (IVUS); superficial femoral artery (SFA).