Authors: E M A Wiegerinck H A Marquering N Y Oldenburger M A Elattar R N Planken B A J M De Mol J J Piek J Baan
Publish Date: 2013/12/11
Volume: 30, Issue: 2, Pages: 399-405
Abstract
The choice of preferred access route for transcatheter aortic valve implantation TAVI is mainly guided by the minimal aortofemoral tract diameter Currently projection angiography XA and CTangiography CTA are used interchangeably to assess this diameter in the TAVI workup We aimed to assess the agreement of XA and CTA diameter measurements in TAVI candidates Diameters of 700 aortailiac segments of 102 TAVI candidates were analyzed on both XA and CTA The diameters on XA were measured manually for the CTAbased analysis semiautomated segmentation software was used Paired sample T test was used to evaluate differences in diameter measurements between the modalities Disagreement on the suitability for a transfemoral TFTAVI approach was identified The interobserver agreement for both measurements was assessed by calculating the intraclass correlation coefficient ICC The average diameters were 101 ± 18 mm and 84 ± 17 for XA and CTA respectively The mean paired difference was 173 mm p 0001 For 18 patients 176 diameters measured on CTA images were bilaterally less than 6 mm whilst XA indicated a minimum diameter exceeding 6 mm For both modalities the interobserver agreement was excellent ICC 095 Diameters measured semiautomatically on CTA were statistically significantly smaller compared to XA This should be acknowledged in the workup for selecting the most appropriate approach for TAVI In our population 176 of patients would have been denied a transfemoral TAVI based on CTA measurements whilst XA suggested diameters sufficient for a TF approach
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