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TABLE OF CONTENTS
List of Contributors xi
Foreword xvii
Introduction xix
Part One
Validation of QCA: In vitro and in vivo, off-line
and on-line studies
1. Why and how should QCA systems be validated? 1
2. Accuracy and precision of quantitative digital
coronary arteriography; observer-. as well as
short- and medium-term variabilities 7
3. How reliable are geometric coronary measurements?
In vitro and in vivo validation of digital and
cinefilm-based quantitative coronary analysis systems
with a didactic methodological explanation 27
4. Validation of videodensitometry in the assessment of
stenosis phantoms: an in vitro and in vivo study 51
5. Videodensitometry in percutaneous coronary interventions:
a critical appraisal of its contributions and limitations 69
Part Two
The QCA core laboratory: practical lessons learned and
application to clinical practice
6. Post-angioplasty lesion measurement variability of the
cardiovascular angiographic analysis system 89
7. Methodological problems with the quantitative angiographic
assessment of elastic recoil, stretch and balloon-artery
ratio 103
8. Experiences of a quantitative coronary angiographic core
laboratory in restenosis prevention trials 121
9. Visual versus quantitative analysis of coronary artery
stenoses treated by coronary angioplasty: can the
angiographer's eye be re-educated? 137
Part Three
Physiological applications of QCA, correlation with
intracoronary physiological measurements obtained by
alternative methodology
10. Intracoronary pressure measurements with a 0.015"
fluid-filled angioplasty guide wire 147
11. Measurement of coronary artery pressure and stenosis
gradients - clinical applications 167
12. Application of coronary flow measurements to decision
making in angioplasty 181
13. On-line versus off-line assessment of coronary flow
reserve 231
14. Calculation ot maximum coronary, myocardial and collateral
blood flow by pressure measurements in the coronary
circulation 243
15. Comparison between fractional flow reserve calculation and
quantitative coronary arteriography in a non-selected
patient population 271
16. Assessment of coronary stenosis severity from simultaneous
measurement of transstenotic pressure gradient and flow. A
comparison with quantitative coronary angiography 283
Part Four
A in the study of vasomotion
17. Application of quantitative coronary angiography in the
study of pharmacologically induced coronary vasomotion 307
18. Long-term responsiveness to intracoronary ergonovine in
variant angina 317
19. Response of conductance and resistance coronary vessels
to scalar concentrations of acetylcholine. Assessment
with quantitative angiography and intracoronary Doppler
in 29 patients with coronary artery disease 329
20. Angiographic evaluation of coronary bypass grafts
vasomotion 355
Part Five
QCA in the setting of acute coronary syndromes,
evaluation of the role of thrombolysis and balloon
angioplasty
21. Evaluation of thrombolytic and monoclonal antiplatelet
GPIIb/IIIa antibody therapy in refractory unstable angina
pectoris: correlation between quantitative assessment of
coronary angiograms and clinical course 371
22. Clinical and quantitative angiographic results of a
randomized trial comparing direct coronary angioplasty
with intravenous streptokinase in acute myocardial
infarction 387
23. Merits of quantitative coronary angiography after
thrombolytic therapy for evolving myocardial infarction 397
Part Six
QCA applied to the evaluation of immediate and long term
outcome followIng coronary balloon angioplasty:
experiences emerging from large multicentre restenosis
prevention trials
24. Elastic recoil after percutaneous transluminal coronary
angioplasty. A quantitative angiographic approach 415
25. The importance of coronary dissection during and after
coronary balloon angioplasty as evaluated by quantitative
coronary angiography 433
26a. Quantitative coronary angiography for the evaluation of
pharmacological restenosis prevention trials after
successful percutaneous transluminal coronary balloon
angioplasty. The results of CARPORT and MERCATOR study.
On behalf of the CARPORT ( Coronary Artery Restenosis
Prevention on Repeated Thromboxane-antagonism) and
MERCATOR (Multicenter European Research trial with
Cilazapril after Angioplasty to prevent Transluminal
coronary Obstruction and Restenosis) study groups 451
26b. Quantitative coronary angiography in the assessment of
risk factors for luminal renarrowing. A study of clinical,
procedural and lesional factors related to long term
angiographic outcome in 2 restenosis prevention trials:
CARPORT and MERCATOR on behalf of the CARPORT (Coronary
Artery Restenosis Prevention on Repeated Thromboxane
antagonism) and MERCATOR (Multicenter European Research
trial with Cilazapril after Angioplasty to prevent
Transluminal coronary Obstruction and Restenosis)
study groups 469
27. Restenosis assessed by quantitative angiography. Lessons
learned from two European multicenter trials 495
Part Seven
Evaluation of new devices and comparison with balloon
angioplasty using QCA
28. Evaluation of the clinical use of directional coronary
atherectomy using quantitative coronary angiography 537
29. Rotational atherectomy 561
30. Critical appraisal of quantitative coronary angiography
and endoluminal stent implantation 573
31. Excimer laser angioplasty 591
32. Evolving quantitative angiographic approaches to the
comparative assessment of luminal renarrowing and long-term
outcome after different transluminal coronary interventions 611
Part Eight
QCA applied to the natural history of atherosclerosis
33. Progression or regression of coronary atherosclerosis:
assessment with quantitative coronary angiography 635
34. Coronary atherosclerosis intervention trials using serial
quantitative angiography 653
35. Short and long-term quantitative angiographic follow-up
after cardiac transplantation 665
Part Nine
Intravascular ultrasound and QCA
36. Does coronary lumen morphology influence vessel cross-
sectional area estimation? An in vitro comparison of
intravascular ultrasound and quantitative coronary
angiography 681
37. Intravascular ultrasound -An evolving rival for
quantitative coronary angiography 695
Index 717
