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Three-dimensional intravascular ultrasound evaluation of carina and plaque shift at the distal left main coronary artery bifurcation after treatment with a one-stent cross-over technique.

Authors
Xiu, J; Choi, SY; Mintz, GS; Araki, H; Masuda, N; Morino, Y; Sonoda, S; Tahk, SJ; Ochiai, M; Maehara, A
Citation
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 81(7):1142-1149, 2013
Journal Title
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN
1522-19461522-726X
Abstract
OBJECTIVE: To assess the geometrical changes in the distal left main coronary artery (LMCA), left anterior descending (LAD), and left circumflex (LCX) that occur after a distal LMCA lesion is treated using a one-stent cross-over strategy.



BACKGROUND: Morphological changes after stent implantation into distal LMCA lesions are not fully understood.



METHODS: We used pre- and postintervention three-dimensional intravascular ultrasound of both the LAD and LCX as well as of the LMCA to evaluate distal LMCA lesions after a 1-stent cross-over strategy. In 38 distal LMCA bifurcation lesions, cross-sectional measurements were performed every 1 mm over a 5-mm segment in the LAD and LCX distal to the carina and over the entire LMCA proximal to the carina.



RESULTS: The increase in lumen volume correlated with the increase in external elastic membrane volumes: R = 0.917, P < 0.001, in the LMCA and R = 0.785, P < 0.001, in the LAD with no decrease in plaque volume except at the distal end of the LMCA (P = 0.081) and at the LAD carina (P = 0.11). The LCX lumen area decreased significantly at the LCX carina from 5.9 ± 2.0 mm(2) to 5.3 ± 1.9 mm(2) (P < 0.01); however, the response was variable from a 4.0 mm(2) decrease to a 1.8 mm(2) increase in lumen area. While the change in LCX lumen area at the carina correlated with the change in vessel area (R = 0.791, P < 0.001), there was also a small increase in plaque area at the LCX carina from 6.4 ± 2.9 mm(2) to 6.8 ± 2.9 mm(2) (P < 0.01).



CONCLUSIONS: LMCA bifurcation lumen changes after cross-over single-stent implantation were determined primarily by conformational changes in vessel geometry.
MeSH terms
AgedAnalysis of VarianceChi-Square DistributionCoronary AngiographyCoronary Artery Disease/mortality/*therapy/*ultrasonographyCoronary Vessels/*ultrasonographyFemaleHumans*Image Interpretation, Computer-Assisted*Imaging, Three-DimensionalJapanMaleMiddle AgedPercutaneous Coronary Intervention/adverse effects/*instrumentation/mortality*Plaque, AtheroscleroticPredictive Value of TestsRisk Factors*StentsTime FactorsTreatment Outcome*Ultrasonography, Interventional
DOI
10.1002/ccd.24681
PMID
23008216
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
최, 소연탁, 승제
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