title: Vascular remodeling at both branch ostia in bifurcation disease assessed by intravascular ultrasound.
abstract: BACKGROUND
  The aim of this study was to assess vascular remodeling at both mainbranch (MB) and sidebranch (SB) ostia in left main (LM), and non-LM coronary artery disease.
  
  
  METHODS
  Using both pullback intravascular ultrasound, MB and SB ostia were evaluated in 169 bifurcation lesions with angiographic stenosis >50% before procedure. Remodeling index (RI) was the ratio of external elastic membrane (EEM) area at the minimal lumen area (MLA) site within the ostium to EEM area of distal reference.
  
  
  RESULTS
  In 81 LM bifurcation lesions, constrictive remodeling (RI < 1) was frequent at MB and SB ostia (91% and 90%). In 88 non-LM bifurcation lesions, constrictive remodeling was also frequent at the MB and SB ostia (76% and 92%). RI was the lowest at the SB ostium in non-LM bifurcation (0.80 ± 0.13). RI was related to neither large plaque burden nor extensive calcification. The non-LM bifurcation lesions with RI <1 at the SB ostium showed smaller distal carina angle (51 ± 25° vs. 64 ± 14°, P = 0.044) compared with those with RI >1. At all ostial sites of bifurcation lesions, plaque burden and RI at the ostium and EEM area of distal reference were the independent factors affecting the MLA within the corresponding ostium as a continuous variable.
  
  
  CONCLUSIONS
  At both MB and SB ostia, constrictive remodeling was frequent even in the lesions with small amount of plaque and minimal calcification, which contribute further luminal narrowing. © 2012 Wiley Periodicals, Inc.
authors: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors: Soo-Jin
authors: SJ
authors: Kang
authors: Won-Jang
authors: WJ
authors: Kim
authors: Sung-Cheol
authors: SC
authors: Yun
authors: Duk-Woo
authors: DW
authors: Park
authors: Seung-Whan
authors: SW
authors: Lee
authors: Young-Hak
authors: YH
authors: Kim
authors: Cheol Whan
authors: CW
authors: Lee
authors: Seong-Wook
authors: SW
authors: Park
authors: Gary S
authors: GS
authors: Mintz
authors: Seung-Jung
authors: SJ
authors: Park
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000000981:diagnostic imaging