{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T07:03:18Z","timestamp":1774940598840,"version":"3.50.1"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patent Ductus Arteriosus (PDA) stenting has become an established albeit complex intervention in ductal dependent congenital heart disease. Accurate pre-procedural planning is essential for successful stent placement, yet the optimal measurement methodology remains debated. This study compared the accuracy and clinical utility of routine pre-procedural three-dimensional (3D) computed tomography-derived measurements with traditional angiographic assessments for PDA stent sizing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed 21 consecutive PDA stenting cases from Sheba Medical Center (01\/2021\u201310\/2023) with a median age of 14 days (IQR: 8\u201319) and mean weight of 3.6\u2009\u00b1\u20092.2\u2005kg. Patients were stratified by anatomical complexity: Group 1 (0 turns,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), Group 2 (1 turn,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), and Group 3 (\u22652 turns,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912). PDA length measurements from CTA-derived 3D reconstruction and 2D angiography were compared against the actual stent length used. Statistical analysis included Pearson correlation, Bland\u2013Altman agreement, and concordance correlation coefficients (CCC).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the overall cohort, both 3D (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.692) and angiographic (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.811) measurements correlated with stent length. Performance varied significantly by anatomical complexity. In Group 1 (straight), angiography demonstrated favorable accuracy with lower bias (\u22120.28\u2005mm vs. 1.33\u2005mm) and higher concordance (CCC: 0.807 vs. 0.681). In Group 2 (moderate tortuosity), angiographic performance showed greater underestimation and lower concordance (Bias \u22125.67\u2005mm; CCC: 0.168), while 3D remained reliable (Bias \u22122.33\u2005mm; CCC: 0.526). In Group 3 (severe tortuosity), 3D overestimated length (+3.1\u2005mm) while angiography underestimated it (\u22122.88\u2005mm), though angiographic consistency was higher (CCC: 0.704 vs. 0.559).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pre-procedural 3D measurements provide consistent reliability across varying degrees of anatomical complexity, offering an advantage in cases with moderate tortuosity where angiography may be vulnerable to foreshortening. Angiography remains highly accurate for straightforward anatomy. A complexity-stratified imaging approach is recommended to optimize stent selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1767627","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T05:32:24Z","timestamp":1774935144000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-procedural three-dimensional computed tomography vs. angiographic assessment for patent ductus arteriosus stenting: a comparative analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"David","family":"Hochstein","sequence":"first","affiliation":[{"name":"Internal Medicine Department C, Sheba Medical Center","place":["Ramat Gan, Israel"]},{"name":"Engineering in Medicine Lab (EiM), Sheba Medical Center","place":["Ramat Gan, Israel"]},{"name":"The School of Medicine, Tel Aviv University","place":["Tel Aviv, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liran","family":"Ceausu","sequence":"additional","affiliation":[{"name":"Engineering in Medicine Lab (EiM), Sheba Medical Center","place":["Ramat Gan, Israel"]},{"name":"The School of Medicine, Tel Aviv University","place":["Tel Aviv, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avshalom","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Engineering in Medicine Lab (EiM), Sheba Medical Center","place":["Ramat Gan, Israel"]},{"name":"The School of Medicine, Tel Aviv University","place":["Tel Aviv, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Netanel","family":"Nagar","sequence":"additional","affiliation":[{"name":"Engineering in Medicine Lab (EiM), Sheba Medical Center","place":["Ramat Gan, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliana","family":"Vajgovski","sequence":"additional","affiliation":[{"name":"Engineering in Medicine Lab (EiM), Sheba Medical Center","place":["Ramat Gan, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yishay","family":"Salem","sequence":"additional","affiliation":[{"name":"The School of Medicine, Tel Aviv University","place":["Tel Aviv, Israel"]},{"name":"The Edmond and Lily Safra Children\u2019s Hospital, Sheba Medical Center","place":["Ramat Gan, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yisrael","family":"Parmet","sequence":"additional","affiliation":[{"name":"Department of Industrial Engineering and Management, Ben Gurion University","place":["Beer Sheva, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shai","family":"Tejman-Yarden","sequence":"additional","affiliation":[{"name":"Engineering in Medicine Lab (EiM), Sheba Medical Center","place":["Ramat Gan, Israel"]},{"name":"The School of Medicine, Tel Aviv University","place":["Tel Aviv, Israel"]},{"name":"The Edmond and Lily Safra Children\u2019s Hospital, Sheba Medical Center","place":["Ramat Gan, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Borik Chiger","sequence":"additional","affiliation":[{"name":"Engineering in Medicine Lab (EiM), Sheba Medical Center","place":["Ramat Gan, Israel"]},{"name":"The School of Medicine, Tel Aviv University","place":["Tel Aviv, Israel"]},{"name":"The Edmond and Lily Safra Children\u2019s Hospital, Sheba Medical Center","place":["Ramat Gan, Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart 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