title: An intravascular ultrasound comparison of left anterior descending artery/first diagonal branch versus distal left main coronary artery bifurcation lesions.
abstract: OBJECTIVE
  We report the intravascular ultrasound (IVUS) analysis of plaque distribution in left anterior descending (LAD) artery/first diagonal (D1) and distal left main coronary artery (LMCA) bifurcation lesion location.
  
  
  RESULTS
  We reviewed 58 angiograms of LAD/D1 bifurcation lesions with pre-intervention IVUS of both the LAD and D1 and compared these data to a corresponding cohort (n=81) of LMCA bifurcations, dividing each bifurcation into three segments: MV (main vessel), MB (main branch distal to the carina), and SB (side branch). In the LAD/D1 cohort, D1 (SB) had less calcium and a smaller plaque burden compared to the other two segments. Continuous plaque from the LAD proximal to the carina (MV) into the LAD distal to the carina (MB) was seen in 90%, from the MV into the SB in 72%, and from the MV into both the MB and SB in 62%. In the LMCA cohort, ostial left circumflex (LCX) (SB) had less calcium and a smaller plaque burden compared to the distal LMCA (MV) and ostial LAD (MB). Continuous plaque from MV to MB was seen in 96%, from MV to the SB in 78%, and from MV to both branches in 74%.
  
  
  CONCLUSIONS
  The IVUS analysis of the LAD/D1 and LMCA bifurcations revealed that most lesions had diffuse plaques extending from the MV into the MB with the SB having the least amount of calcium and the smallest plaque burden, regardless of location.
authors: The Cardiovascular Research Foundation and Columbia University Medical Center, 111 East 59th Street, New York, NY 10022, USA.
authors: Tadayuki
authors: T
authors: Yakushiji
authors: Akiko
authors: A
authors: Maehara
authors: Gary S
authors: GS
authors: Mintz
authors: Shigeo
authors: S
authors: Saito
authors: Hiroshi
authors: H
authors: Araki
authors: Carlos
authors: C
authors: Oviedo
authors: So-Yeon
authors: SY
authors: Choi
authors: Seung Jea
authors: SJ
authors: Tahk
authors: Martin B
authors: MB
authors: Leon
authors: Gregg W
authors: GW
authors: Stone
authors: Jeffrey W
authors: JW
authors: Moses
authors: Masahiko
authors: M
authors: Ochiai
mesh_terms: D000368:Aged; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D023921:Coronary Stenosis / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012189:Retrospective Studies; D015607:Stents; D018084:Ultrasonography, Interventional