title: Eccentric morphology of jailed side-branch ostium after stent crossover in coronary bifurcation lesions: a three-dimensional optical coherence tomographic analysis.
abstract: BACKGROUND
  Angiographic stenosis of a jailed side-branch ostium is usually observed after a single-stent crossover at coronary bifurcation lesions. However, the stenosis severity is typically overestimated due to the limited information obtained from two-dimensional morphology by angiography. We evaluated the actual stenosis of jailed side-branch ostium using three-dimensional (3D) optical coherence tomography (OCT).
  
  
  METHODS
  Using 3D reconstructions of OCT data, we analyzed minimal lumen area (MLA) and eccentricity of the jailed side-branch ostium in 41 patients who were treated with single stent crossover at coronary bifurcation lesions and subsequently underwent serial OCT follow-up.
  
  
  RESULTS
  The MLA of jailed side-branch ostium calculated from quantitative coronary angiography (QCA) assuming a circular lumen markedly decreased after stent implantation (1.73±1.22mm(2) pre-intervention to 0.84±0.91mm(2) post-intervention, p<0.001). However, the MLA of jailed side-branch ostium measured at post-intervention by 3D-OCT (2.67±1.75mm(2)) was significantly larger than that measured by QCA (p<0.001). There were no statistically significant changes in MLA of jailed side-branch ostium based on 3D-OCT measurements during the follow-up (2.35±1.50mm(2) at 3-6 months post-intervention; 2.44±1.27mm(2) at 1-2 years post-intervention, p=0.098). The shapes of the jailed side-branch ostium were nearly elliptical (mean eccentricity index: 2.97±1.27 post-intervention; 2.79±1.17 at 3-6 months post-intervention; 2.59±1.02 at 1-2 years post-intervention).
  
  
  CONCLUSIONS
  Compared to 3D-OCT measurements, QCA measurements overestimated the jailed side-branch ostial stenosis after single stent crossover due to eccentric morphology from orthogonal projection in coronary angiography. Significant changes in the MLA of jailed side-branch ostium by 3D-OCT were not observed during the follow-up.
authors.affiliation: Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Pil-Sung
authors.initials: PS
authors.lastname: Yang
authors.affiliation: Department of Optical Engineering, Sejong University, Seoul, Republic of Korea.
authors.forename: Jinyong
authors.initials: J
authors.lastname: Ha
authors.affiliation: Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Optical Engineering, Sejong University, Seoul, Republic of Korea.
authors.forename: Seungsu
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Optical Engineering, Sejong University, Seoul, Republic of Korea.
authors.forename: Jinju
authors.initials: J
authors.lastname: Bae
authors.affiliation: Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Shin
authors.affiliation: Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Byeong-Keuk
authors.initials: BK
authors.lastname: Kim
authors.affiliation: Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.affiliation: Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.affiliation: Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.affiliation: Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea; Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: mkhong61@yuhs.ac.
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000601:surgery; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015607:Stents; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: Bifurcation; Optical coherence tomography; Stent