A Novel Non-Invasive Method In Order To Rule Out Coronary Artery Stenosis Prior To Peripheral Arterial Surgery: Artificial Intelligence Analyzed Vectorcardiography.

OBJECTIVE Atherosclerosis and associated coronary artery disease may complicate the stenosis of larger sized arteries such as abdominal aorta, ileac and carotid arteries. Undetected stable coronary artery disease may increase the morbidity and mortality of such surgical interventions. In traditional medical approach, a coronary angiography is usually performed prior to peripheral arterial revascularization in order to rule out coronary arterial involvement. Herein, we would like to share two cases whom an artificial intelligence (AI) analyzed vectorcardiography was used for the abovementioned purpose. The sensitivity of AI-assisted Cardisiography in order to exclude stable coronary artery disease is 97% for males and 90% for females. METHODS Cardisiography focuses on spatial and temporal heterogeneity of cardiac excitation using vectorcardiography with a five-fold nested cross-validation in comparison to angiographic findings1. Two patients, one male with the diagnosis of Leriche Syndrome and one female with bilateral carotid artery stenosis were evaluated with AI-assisted Cardisiography prior to coronary angiography. Cardisiography revealed no significant probability with regard to vectorcardiography and AI based supervised machine learning algorhythms. Afterwards, conventional coronary angiographies were performed and any stenosis in the coronary vascular bed was excluded. Case-1: 42 years old male who had symptoms and clinical findings of Leriche Syndrome (claudication, erectile impotence and diminished peripheral pulses) (Figure-1). Following preoperative evaluation, an aorta-bifemoral bypass graft was interposed uneventfully. Case-2: 55 years old female patient was admitted to our clinic with dizziness and transient ischemic attack. Carotis artery angiography revealed critical stenosis at the left and moderate stenosis at the right internal carotid arteries (Figure-2). A carotid endarterectomy and saphenous vein patch plasty were uneventfully performed. RESULTS Coronary artery involvement in peripheral arterial disease is an important association, since ruling out a critical coronary artery stenosis is deemed mandatory prior to revascularization of carotid arteries, abdominal aorta, ileac arteries and distal branches. AI-assisted Cardisiography may be used as a noninvasive alternative method in the diagnosis of stable coronary artery disease, especially when surgery for carotid artery stenosis is based on Doppler ultrasonographic findings alone (i.e., without performing CT angiography or conventional angiography prior to surgery). CONCLUSIONS AI-assisted Cardisiography may be used as an alternative non-invasive method in order to rule out stable coronary artery disease in patients undergoing peripheral vascular surgery, decreasing the need for conventional angiography. Further large-scale clinical trials will be needed, before further assumptions can be drawn. [ABSTRACT FROM AUTHOR]