Novel Method for Real Time Co-Registration of Coronary Physiology and Angiography

Aaron Frimerman1, Rami, Abu-Fane1, Yaniv Levi1, Ariel Roguin2
1 Cardiology, Hillel-Yaffe Medical Center, Israel
2 Cardiology, Rambam Medical Center, Israel

Affiliated to Rappaport Faculty of Medicine, Technion, Haifa,Israel.

Objectives: We present our experience with a novel method for real time co-registration of coronary physiology and angiography.

Background: A major limitation of the current practice of concomitant use of coronary angiography and physiology (FFR/iFR) is that the locations of the acquired pressure indices are not correlated with their exact locations on the vessel roadmap obtained by coronary angiography.

Methods: Phantoms simulating the coronary tree were used to test the accuracy and potential of co-registration. Subsequently we examined patients who underwent iFR pullback study during cardiac catheterization. Analysis and feasibility were performed in 40 arteries of 35 patients.

Results: The statistical validation in phantoms resulted in a mean co-registration accuracy of 2 mm. The length measurement on an angiogram resulted in a mean accuracy of 1.2 mm. Co-registration in patients was successful in all cases and four categories were assisted by 1(unacceptable) to 5 (Excellent) grading: Characterizing the disease (4.3 ± 0.8), which lesion(s) to treat (4.5±0.8), selecting stent position (4.4±0.9) and stent dimensions (4.2±0).

Conclusions: In this pilot study, we found that the novel physiology and coronary angiography co-registration method is a valid and accurate method to determine coronary artery lesions severity and to guide for an optimal treatment of these lesions, mainly in borderline and diffuse lesions.

Dr. Aaron Frimerman

Hillel Yaffe Medical Center