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Three-Dimensional Optical Coherence Tomographic Analysis of Eccentric Morphology of the Jailed Side-Branch Ostium in Coronary Bifurcation Lesions.

 Sungsoo Cho  ;  Jung-Sun Kim  ;  Jinyong Ha  ;  Dong-Ho Shin  ;  Byeong-Keuk Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong-Ki Hong 
 CANADIAN JOURNAL OF CARDIOLOGY, Vol.32(2) : 234-239, 2016 
Journal Title
Issue Date
Coronary Angiography ; Coronary Stenosis/diagnosis* ; Coronary Stenosis/physiopathology ; Coronary Stenosis/surgery ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/pathology* ; Coronary Vessels/surgery ; Female ; Follow-Up Studies ; Fractional Flow Reserve, Myocardial ; Humans ; Imaging, Three-Dimensional/methods* ; Male ; Middle Aged ; Myocardial Revascularization/methods ; Retrospective Studies ; Severity of Illness Index ; Stents ; Tomography, Optical Coherence/methods*
BACKGROUND: The severity of angiographic diameter stenosis of the jailed side-branch ostium is usually overestimated over the 3-D optical coherence tomography (OCT)-measured actual stenosis. Using 3-D OCT, morphologic changes in the jailed side-branch ostium were evaluated before and after a single stent crossover at coronary bifurcation lesions. METHODS: In 109 patients who received a single stent crossover at coronary bifurcation lesions, the minimal lumen area (MLA) before and after intervention and the eccentricity of the jailed side-branch ostium were measured with 3-D OCT. The eccentricity index was defined as the ratio of maximal diameter/minimal diameter of the jailed side-branch ostium. When the eccentricity index was < 1.5, the shape of the jailed side-branch ostium was defined as circular. The MLA of the jailed side-branch ostium was also calculated from the quantitative coronary angiography (QCA) minimal lumen diameter assuming a circular lumen. RESULTS: The 3-D OCT-measured MLA of the jailed side-branch ostium decreased from 2.91 ± 1.65 mm(2) before intervention to 2.37 ± 1.48 mm(2) after intervention (P < 0.01). The QCA-derived MLA also decreased from 2.35 ± 1.71 mm(2) before intervention to 1.68 ± 1.56 mm(2) after intervention (P < 0.01). However, the 3-D OCT-measured MLA was significantly larger than the QCA-derived MLA (P < 0.01). The shape of the jailed side-branch ostium changed from circular to elliptical after the stent implantation (eccentricity index: 1.40 ± 0.33 before intervention; 1.71 ± 0.60 after intervention; P < 0.01). CONCLUSIONS: Compared with QCA measurements, 3-D OCT analysis could be useful to guide decisions regarding additional intervention after stent implantation across coronary bifurcation lesions.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Shin, Dong Ho(신동호) ORCID logo https://orcid.org/0000-0002-7874-5542
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
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