Edge detection versus videodensitometry for quantitative angiographic assessment of directional coronary atherectomy

The immediate efficacy of coronary atherectomy should be established by reproducible quantitative coronary analysis.1 The term “directional atherectomy” suggests that the device can be selectively directed toward the plaque and that its cutting mechanism is potentially less disruptive on vascular architecture than other angioplasty modalities. As a result of this selectively debulking action, the vessel may assume a more circular configuration, and cross-sectional area measurements obtained by edge detection and videodensitometry should become more comparable. This study was undertaken to determine whether videodensitometry and edge detection were equally acceptable methods in assessing the immediate results after atherectomy since the optimal method has not yet been established. Cineangiograms of 20 patients who underwent directional coronary atherectomy were analyzed with a computer-based coronary angiographic analysis system. The results of the cross-sectional area derived from contour analysis and videodensitometry were compared before and after directional atherectomy.