Is intravascular ultrasound better than quantitative coronary arteriography to assess cardiac allograft arteriopathy?

Optimal methods to detect and quantify allograft arteriopathy have not been established. Both arteriography and intravascular ultrasound have been used to evaluate vessel lumen diameter and area and arterial wall thickness in patients following cardiac transplantation, although due to the anatomically diffuse nature of this disease, neither technique has been accepted as the diagnostic 'gold standard'. To determine the usefulness of quantitative angiography to detect transplant-related coronary artery disease compared to intravascular ultrasound, 25 patients underwent both procedures following cardiac transplantation (20 <1 year, 5 >1 year). Lumen diameter and area measurements of proximal coronary artery segments were compared using both techniques. Overall, lumen diameter and area measurements correlated closely between the two procedures, both for the early and late follow-up patients. However, because of the ability to characterize changes more precisely in coronary vessel shape and wall thickness, intravascular ultrasound offered distinct advantages over routine coronary angiography and is probably the technique of choice to evaluate allograft arteriopathy.