Comparison of vessel geometry in bifurcation between normal and diseased segments: intravascular ultrasound analysis.
OBJECTIVE
To investigate the geometry in bifurcation using intravascular ultrasound (IVUS) analysis.


METHODS
We performed quantitative three-dimensional IVUS analysis of 31 true bifurcation lesions and 30 angiographically normal bifurcation segments including the main and side branches as well as parent vessel.


RESULTS
The external elastic membrane (EEM) area changed significantly according to distance from bifurcation in the parent vessel and main branches of the lesion group while there was no significant change in the EEM area in the normal group. Vessel size of bifurcation segments obeyed the principle of minimum work (Murray's law). The cube of the mean EEM diameter of parent vessel nearly equaled the sum of the cubes of the mean EEM diameters of main and side branches (95.5 +/- 38.9 mm(3) versus 90.7 +/- 36.1 mm(3) for the lesion group and 93.4 +/- 49.6 mm(3) versus 85.3 +/- 47.3 mm(3) for the normal group). However, the deviation from the optimal relationship of lumen size was noted more frequently in bifurcation lesion than normal bifurcation segments (71% versus 43%, P=0.03).


CONCLUSIONS
The EEM pattern may differ between bifurcation lesions and normal bifurcating segments. Although human coronary artery system obeys the principle of minimum work, the geometry may deviate from the optimal relationship in bifurcation lesions.
Hahn
Joo-Yong
JY
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-Gu, Seoul, Republic of Korea.
Gwon
Hyeon-Cheol
HC
Kwon
Sung Uk
SU
Choi
Seung-Hyuk
SH
Choi
Jin-Ho
JH
Lee
Sang Hoon
SH
Hong
Kyung-Pyo
KP
Park
Jeong Euy
JE
Kim
Duk Kyung
DK
D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000473:pathology; D023921:Coronary Stenosis / Q000473:pathology; D003331:Coronary Vessels / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018084:Ultrasonography, Interventional / Q000379:methods*