TECHNIQUES FOR DETECTION OF LESIONS IN CORONARY ARTERIES

  • Ritman, Erik L (PI)

Project: Research project

Project Details

Description

The objective of this proposal is to quantitate atheromatous
plaque volume in major epicardial coronary arteries by minimally
invasive means. This objective is motivated by the need to make
presymptomatic detection of coronary artery stenoses and the
need to monitor the progression, or regression, of atheromatous
plaques over a period of time. We propose to use the Dynamic Spatial Reconstructor (DSR), a
fast multislice x-ray CT scanner that has recently been modified
to permit quantitation of 25-50% stenoses in a 2mm diameter
coronary artery using a central venous bolus injection of contrast
medium. In the current proposal we request funds to upgrade the
Charge Coupled Device (CCD) television camera based x-ray
image chains on the DSR from the current analog mode of
operation to all digital, 'on gantry', operation so as to provide the
increased resolution needed for the technically more demanding
task of this proposal. We propose to use the Biosound 12mHz sector scanner
intraoperatively immediately after onset of cardioplegia, just
prior to commencing revascularization, to provide the true
volume of plaque from several cross section images along the left
anterior descending coronary artery in the region of the selected
stenosis. The value would be compared to the volume of plaque
computed from the presurgical DSR scan. The DSR scan would be
performed on all consenting patients selected for coronary bypass
surgery on the basis of their clinically indicated coronary
arteriogram. Past DSR studies of dogs have shown that the volume of hollow
cylindrical plastic plugs introduced into coronary arteries could be
quantitated over a range from 5mm3 to 25mm3, with a standard
error of the estimate of 2mm3. These cylinders were
approximately 2mm long and 2-3mm outside diameter, resulting in
50-80% stenoses of the vessel lumen. This method, if successful,
would in conjunction with the other demonstrated capabilities of
the DSR images, provide quantitation of the presence and severity
of a coronary stenosis, the volume of the plaque causing the
stenosis and the impact on myocardial perfusion distal to the
stenosis; all from a single central venous injection of contrast
agent.
StatusFinished
Effective start/end date8/1/875/31/92

Funding

  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health

ASJC

  • Medicine(all)

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