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An intravascular ultrasound comparison of left anterior descending artery/first diagonal branch versus distal left main coronary artery bifurcation lesions.

Authors
Yakushiji, T; Maehara, A; Mintz, GS; Saito, S; Araki, H; Oviedo, C; Choi, SY; Tahk, SJ; Leon, MB; Stone, GW; Moses, JW; Ochiai, M
Citation
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 8(9):1040-1046, 2013
Journal Title
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
ISSN
1774-024X1969-6213
Abstract
AIMS: We report the intravascular ultrasound (IVUS) analysis of plaque distribution in left anterior descending (LAD) artery/first diagonal (D1) and distal left main coronary artery (LMCA) bifurcation lesion location.



METHODS AND RESULTS: We reviewed 58 angiograms of LAD/D1 bifurcation lesions with pre-intervention IVUS of both the LAD and D1 and compared these data to a corresponding cohort (n=81) of LMCA bifurcations, dividing each bifurcation into three segments: MV (main vessel), MB (main branch distal to the carina), and SB (side branch). In the LAD/D1 cohort, D1 (SB) had less calcium and a smaller plaque burden compared to the other two segments. Continuous plaque from the LAD proximal to the carina (MV) into the LAD distal to the carina (MB) was seen in 90%, from the MV into the SB in 72%, and from the MV into both the MB and SB in 62%. In the LMCA cohort, ostial left circumflex (LCX) (SB) had less calcium and a smaller plaque burden compared to the distal LMCA (MV) and ostial LAD (MB). Continuous plaque from MV to MB was seen in 96%, from MV to the SB in 78%, and from MV to both branches in 74%.



CONCLUSIONS: The IVUS analysis of the LAD/D1 and LMCA bifurcations revealed that most lesions had diffuse plaques extending from the MV into the MB with the SB having the least amount of calcium and the smallest plaque burden, regardless of location.
MeSH terms
AgedCohort StudiesCoronary AngiographyCoronary Artery Disease/epidemiology/radiography/*ultrasonographyCoronary Stenosis/therapyCoronary Vessels/pathology/radiography/*ultrasonographyFemaleHumansIncidenceMaleMiddle AgedPercutaneous Coronary Intervention/methodsPlaque, Atherosclerotic/epidemiology/radiography/*ultrasonographyRetrospective StudiesStents*Ultrasonography, Interventional
DOI
10.4244/EIJV8I9A160
PMID
23339810
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
최, 소연탁, 승제
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