Intravascular ultrasound and 3D angle measurements of coronary bifurcations

Objective: To standardize the intravascular ultrasound (IVUS) analysis of coronary bifurcations. Background: Percutaneous treatment of bifurcation lesions is difficult particularly at the side branch ostium. Imaging techniques may improve our understanding of treatment options. There is no establish...

Full description

Saved in:
Bibliographic Details
Published in:Catheterization and cardiovascular interventions Vol. 73; no. 7; pp. 910 - 916
Main Authors: van der Waal, Eva C., Mintz, Gary S., Garcia-Garcia, Hector M., Bui, Anh B., Pehlivanova, Marieta, Girasis, Chrysafios, Serruys, Patrick W., van der Giessen, Wim J., Weissman, Neil J.
Format: Journal Article
Language:English
Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.06.2009
Subjects:
Aged
angiography
Angioplasty, Balloon, Coronary
bifurcation
Coronary Angiography
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - therapy
Coronary Vessels - diagnostic imaging
Databases as Topic
Female
Humans
Image Interpretation, Computer-Assisted - standards
Imaging, Three-Dimensional - standards
intravascular ultrasound
Male
Middle Aged
Patient Selection
percutaneous coronary intervention
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted
Ultrasonography, Interventional - standards
ISSN:1522-1946, 1522-726X, 1522-726X
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective: To standardize the intravascular ultrasound (IVUS) analysis of coronary bifurcations. Background: Percutaneous treatment of bifurcation lesions is difficult particularly at the side branch ostium. Imaging techniques may improve our understanding of treatment options. There is no established IVUS methodology to assess the bifurcation. The present study aims to develop standards for bifurcation imaging. Methods: Quantitative IVUS analysis and 3D bifurcation angle measurements were performed in 34 patients who were selected from the Washington Hospital Center Database. Patients were included if both left anterior descending (LAD) and first diagonal (DX) pullbacks in the same procedure were done. Angiograms were available in 27 patients to measure the 3D bifurcation angle using specialized software. Pullbacks were analyzed proximal and distal to the bifurcation, and at the bifurcation. Results: ProxLAD versus ProxLAD(DX) were similar for vessel area (15.5 ± 4.6 mm2 vs. 15.9 ± 4.0 mm2, P = 0.19), lumen area (8.3 ± 3.6 mm2 vs. 8.6 ± 3.3 mm2, P = 0.25), and plaque area (7.2 ± 2.0 mm2 vs. 7.3 ± 1.9 mm2, P = 0.55). However, BifurcationLAD was larger than BifurcationDX for vessel area (17.3 ± 4.0 mm2 vs. 16.6 ± 3.9 mm2, P = 0.0083). The 3D angiographic bifurcation angle was 50° ± 13° (range of 26°–84°), and did not affect the IVUS measurements. IVUS analysis showed that bifurcation lesions did obey Murray's Law, as ProxLAD lumen area measured 36.7 ± 25.1 mm3 versus DistLAD/DistDX measured 38.0 ± 29.1 mm3, P = 0.56. Conclusions: Two IVUS pullbacks should be performed for a complete assessment of the bifurcation and comparison with Murray's Law. The proposed IVUS analysis was not influenced by the bifurcation angle. © 2009 Wiley‐Liss, Inc.
Bibliography:Conflict of interest: Nothing to report.
ArticleID:CCD21965
istex:A324A20497A12A78047AD4EA29F239154B57DAA3
ark:/67375/WNG-NWBX3RB9-7
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1522-1946
1522-726X
1522-726X
DOI:10.1002/ccd.21965