title: Impact of branching angle on neointimal coverage of drug-eluting stents implanted in bifurcation lesions.
abstract: OBJECTIVE
  To investigate the impact of branching angle (BA) on neointimal coverage of drug-eluting stents (DESs) in bifurcation lesions.
  
  
  BACKGROUND
  Previous experimental studies indicated that BA influences the local flow turbulence and wall shear stress, which are associated with neointimal coverage of DESs.
  
  
  METHODS
  Fifty-five bifurcation lesions in 47 patients were evaluated by serial optical coherence tomography (OCT) before DES implantation and at follow-up. Neointimal coverage was assessed in cross-sectional OCT images containing the side branch; regions including the side branch ostium (SO) and vessel wall (VW) were assessed separately. BA was measured using angiography (Angio-BA) and longitudinal OCT imaging (OCT-BA).
  
  
  RESULTS
  In the SO region, a significant negative correlation was found between the uncovered strut percentage and Angio-BA or OCT-BA (r=-0.41, P=0.0024; r=-0.33, P=0.0167, respectively) and a significant positive correlation was found between Angio-BA and average neointimal thickness (r=0.31, P=0.025), whereas no correlation was observed between OCT-BA and average neointimal thickness (r=0.20, P=0.158). In the VW region, no correlation was found between Angio-BA or OCT-BA and the uncovered strut percentage or average neointimal thickness.
  
  
  CONCLUSIONS
  BA influence the neointimal coverage over DES struts in the SO at coronary bifurcation lesions, but not in those attached to the VW.
authors.affiliation: aFirst Department of Internal Medicine Nara Medical University, Nara bDivision of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kita
authors.forename: Yu
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Goryo
authors.forename: Tomoya
authors.initials: T
authors.lastname: Ueda
authors.forename: Tsunenari
authors.initials: T
authors.lastname: Soeda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okayama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okura
authors.forename: Teruyoshi
authors.initials: T
authors.lastname: Kume
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058426:Neointima; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome