title: A computational atlas of normal coronary artery anatomy.
abstract: OBJECTIVE
  The aim of this study was to define the shape variations, including diameters and angles, of the major coronary artery bifurcations.
  
  
  RESULTS
  Computed tomographic angiograms from 300 adults with a zero calcium score and no stenoses were segmented for centreline and luminal models. A computational atlas was constructed enabling automatic quantification of 3D angles, diameters and lengths of the coronary tree. The diameter (mean±SD) of the left main coronary was 3.5±0.8 mm and the length 10.5±5.3 mm. The left main bifurcation angle (distal angle or angle B) was 89±21° for cases with, and 75±23° for those without an intermediate artery (p<0.001). Analogous measurements of diameter and angle were tabulated for the other major bifurcations (left anterior descending/diagonal, circumflex/obtuse marginal and right coronary crux). Novel 3D angle definitions are proposed and analysed.
  
  
  CONCLUSIONS
  A computational atlas of normal coronary artery anatomy provides distributions of diameter, lengths and bifurcation angles as well as more complex shape analysis. These data define normal anatomical variation, facilitating stent design, selection and optimal treatment strategy. These population models are necessary for accurate computational flow dynamics, can be 3D printed for bench testing bifurcation stents and deployment strategies, and can aid in the discussion of different approaches to the treatment of coronary bifurcations.
authors.affiliation: University of Auckland, Auckland, New Zealand.
authors.forename: Pau
authors.initials: P
authors.lastname: Medrano-Gracia
authors.forename: John
authors.initials: J
authors.lastname: Ormiston
authors.forename: Mark
authors.initials: M
authors.lastname: Webster
authors.forename: Susann
authors.initials: S
authors.lastname: Beier
authors.forename: Alistair
authors.initials: A
authors.lastname: Young
authors.forename: Chris
authors.initials: C
authors.lastname: Ellis
authors.forename: Chunliang
authors.initials: C
authors.lastname: Wang
authors.forename: Örjan
authors.initials: Ö
authors.lastname: Smedby
authors.forename: Brett
authors.initials: B
authors.lastname: Cowan
mesh_terms: D000072226:Computed Tomography Angiography; D003331:Coronary Vessels / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values