Visual versus quantitative analysis of coronary artery stenoses treated by coronary angioplasty: can the angiographer’s eye be re-educated?

Visual interpretation of the degree of coronary artery stenoses may be grossly erroneous when compared with quantitative coronary angiography [1–7]: angiographers tend to overestimate the severity of tight stenoses and underestimate the degree of milder ones [4, 8, 9], a tendency which is particularly unfortunate when the results of interventional procedures such as coronary angioplasty must be “objectively” assessed [9–11]. Quantitative coronary angiography is now established as the “gold standard” for coronary stenosis assessment but its limitations have been recently emphasized [12] and it remains a time consuming technique, so that the use of digital calipers, an easier though less precise method, has been proposed for clinical purposes [5, 8].