RT Journal Article
SR Electronic
T1 Correlation between intracranial vertebral artery stenosis diameter measured by digital subtraction angiography and cross-sectional area measured by optical coherence tomography
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 1002
OP 1006
DO 10.1136/neurintsurg-2020-016835
VO 13
IS 11
A1 Yao Feng
A1 Tingxia Wu
A1 Tao Wang
A1 Yingying Li
A1 Mengyue Li
A1 Long Li
A1 Bin Yang
A1 Xuesong Bai
A1 Xiao Zhang
A1 Yabing Wang
A1 Peng Gao
A1 Yanfei Chen
A1 Yan Ma
A1 Liqun Jiao
YR 2021
UL http://jnis.bmj.com/content/13/11/1002.abstract
AB Background Intracranial vertebral artery (V4 segment) stenosis quantification traditionally uses the narrowest stenosis diameter. However, the stenotic V4 lumen is commonly irregularly shaped. Optical coherence tomography (OCT) allows a more precise calculation of V4 geometry. We compared the narrowest diameter stenosis (DS), measured by digital subtraction angiography (DSA), with the area stenosis (AS), measured by OCT. We hypothesized that DS is the gold standard for measuring the degree of stenosis.Methods Five neuroradiologists evaluated 49 stenosed V4 segments in a blinded protocol. V4 stenosis was measured in millimeters on DSA at its narrowest diameter. OCT was used to estimate the cross-sectional luminal area. We also used automated software to measure DS. Three different angles (anterior, lateral, and oblique views) were used for calculations, and the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and Warfarin–Aspirin Symptomatic Intracranial Disease (WASID) methods were used in all measurements. Spearman’s R values were calculated. Non-linear regression analysis was performed between the DS and AS, with statistically different correlations.Results A high correlation was observed between the WASID and NASCET methods to measure DS with observer measurement and automated software. A good correlation was found between DS measured by observers and AS measured by OCT. Non-linear regression analysis showed that only observer measurement using the oblique view and the WASID method could attain statistically significant differences, but it was weak (r=0.389).Conclusion Measurement of the narrowest diameter was not a reliable predictor of the cross-sectional area of V4 stenosis. Larger studies are therefore needed to develop a new evaluation system based on V4 stenosis.Data are available upon reasonable request. The data used to support the findings of this study are available from the corresponding author upon request.