The following is a summary of “Reproducibility of Femoropopliteal Artery Intravascular Ultrasound Imaging in Patients With Peripheral Artery Disease,” published in the July 2023 issue of the Cardiovascular Disease by Soney et al.

Despite the heightened utilization of intravascular ultrasound (IVUS) in peripheral artery interventions, there is a need for more evidence regarding the reproducibility of IVUS measurements and their correlation with angiography. About 40 cross-sectional intravascular ultrasound (IVUS) images of the femoropopliteal artery from 20 randomly selected patients enrolled in the XLPAD (Excellence in Peripheral Artery Disease) registry who underwent peripheral artery interventions and met criteria based on IVUS consensus guidelines were independently assessed by 2 blinded readers. IVUS images from six patients (40 photos) were chosen for angiographic correlation and satisfied the criteria for discernible anatomical features (e.g., stent boundary and branching point). 

The cross-sectional area (CSA) of the lumen, the cross-sectional area (CSA) of the external elastic membrane (EEM), the diameter of the lumen, and the diameter of the reference vessel were measured multiple times. The intra-observer agreement for Lumen CSA and EEM CSA, as determined by Spearman rank-order correlation (ρ), was more significant than 0.993. Additionally, the intraclass correlation coefficient was more remarkable than 0.997, and the repeatability coefficient was less than 1.34. In the context of interobserver measurement of luminal cross-sectional area (CSA) and external elastic membrane (EEM) CSA, the correlation coefficients (ρ) were found to be 0.742 and 0.764. 

The intraclass correlation coefficients were also determined to be 0.888 and 0.885 for luminal CSA and EEM CSA, respectively. The repeatability coefficients were calculated to be 7.24 and 11.34 for luminal CSA and EEM CSA, respectively. A Bland–Altman plot was utilized to assess the reproducibility of the lumen and EEM CSA, which demonstrated favorable results. Regarding angiographic comparison, the correlation coefficients (ρ) for luminal diameter, luminal area, and vessel area were 0.419, 0.414, and 0.649, respectively. The femoropopliteal intravascular ultrasound (IVUS) measurements exhibited robust intra-observer and interobserver concordance, whereas the IVUS and angiographic measurements did not reveal a comparable level of agreement.

Source: sciencedirect.com/science/article/pii/S0002914923002436