New Insights Into the Coronary Artery Bifurcation

• DOI: 10.1016/j.jcin.2011.06.004
• Publication Date: 2011-08-17T01:14:55Z
• Authors: Vasim Farooq; Patrick W. Serruys; Jung Ho Heo; Bill D. Gogas; Takayuki Okamura; Josep Gomez-Lara; Salvatore Brugaletta; Hector M. Garcìa-...; Robert Jan van Geuns
• Keywords: carina shift; FD-OCT; 3-dimensional; Coronary Artery Disease; Prognosis; 03 medical and health sciences; Imaging, Three-Dimensional; 0302 clinical medicine; Predictive Value of Tests; bifurcation; Image Interpretation, Computer-Assisted; Humans; Angioplasty, Balloon, Coronary; Cardiology and Cardiovascular Medicine; Software; Tomography, Optical Coherence; EMC COEUR-09

Coronary artery bifurcations are a common challenging lesion subset accounting for approximately 10% to 20% of all percutaneous coronary interventions. The provisional T-stenting approach is generally recommended as the first-line management of most lesions. Carina shift is suggested to be the predominant mechanism of side-branch pinching during provisional T-stenting and has been indirectly inferred from bench work and other intravascular imaging modalities. Offline 3-dimensional (3D) reconstructions of patients studied in the first-in-man trial of the high-frequency (160 frames/s) Terumo optical frequency domain imaging system were undertaken using volume-rendering software. Through a series of 3D reconstructions, several novel hypothesis-generating concepts are presented.