The bifurcation study using 64 multislice computed tomography.
BACKGROUND
Various two-stent techniques have been applied to aggressively treat bifurcation lesions as the introduction of drug-eluting stents (DES) and the importance of the bifurcation angle and three-dimensional (3D) structure has come to be recognized. Recent 64 multislice computed tomography (MSCT) technology provides accurate information about the 3D bifurcation geometry of the coronary arteries and with reproducibility.


OBJECTIVE
The purpose of this study is to disclose the coronary bifurcation angle and 3D structure in humans and elucidate the importance of bifurcation angle for the crush technique using MSCT.


METHODS
Two hundred and nine patients who were suspected to have angina pectoris and underwent CT angiography using MSCT were examined. The 3D-volume rendering (VR) image was reconstructed by two technicians and was used for the assessment of each coronary bifurcation angles.


RESULTS
The average LMT bifurcation angles (angle LMT-LAD, angle LMT-LCx, angle LAD-LCx) were 143 +/- 13 degrees , 121 +/- 21 degrees , and 72 +/- 22 degrees , respectively, the average angle LAD-D was 138 +/- 19 degrees , the average angle LCx-OM was 134 +/- 23 degrees , the average distal RCA bifurcation angles (angle RCA-4AV, angle RCA-4PD, angle 4AV-4PD) were 152 +/- 15 degrees , 137 +/- 20 degrees , and 61 +/- 21 degrees , respectively. In addition, a percentage of steep angled bifurcation (<110 degrees ) was significantly higher in the LMT (26%) than in other bifurcations (P < 0.05).


CONCLUSIONS
LMT bifurcation has been shown to have a higher rate of steep angled bifurcation in humans, it is therefore necessary to take the bifurcation angle into consideration in the case of LMT stenting. These data suggest that a bifurcation study using MSCT can clarify the 3D structure of coronary bifurcation and may provide useful information for bifurcation stenting.
Kawasaki
Tomohiro
T
Department of Cardiology, Cardiovascular Center, Shin-Koga Hospital, Kurume 830-8577, Japan. kawasaki@mug.biglobe.ne.jp
Koga
Hisashi
H
Serikawa
Takeshi
T
Orita
Yoshiya
Y
Ikeda
Shinsuke
S
Mito
Takahiro
T
Gotou
Yoshitaka
Y
Shintani
Yoshiaki
Y
Tanaka
Atsushi
A
Tanaka
Hidenori
H
Fukuyama
Takaya
T
Koga
Nobuhiko
N
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D015607:Stents; D014057:Tomography, X-Ray Computed