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

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• 作者：Sungsoo Cho ; MD^a ; Jung-Sun Kim ; MD^a ; ^b ; Jinyong Ha ; PhD^c ; Dong-Ho Shin ; MD ; MPH^a ; ^b ; Byeong-Keuk Kim ; MD^a ; ^b ; Young-Guk Ko ; MD^a ; ^b ; Donghoon Choi ; MD^a ; ^b ; Yangsoo Jang ; MD^a ; ^b ; ^d ; Myeong-Ki Hong ; MD^a ; ^b ; ^d ; ^{mkhong61@yuhs.ac" class="auth_mail" title="E-mail the corresponding author}
• 刊名：Canadian Journal of Cardiology
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：32
• 期：2
• 页码：234-239
• 全文大小：815 K

文摘

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 mm² before intervention to 2.37 ± 1.48 mm² after intervention (P < 0.01). The QCA-derived MLA also decreased from 2.35 ± 1.71 mm² before intervention to 1.68 ± 1.56 mm² 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.