Document Detail


Three-dimensional intravascular ultrasound evaluation of carina and plaque shift at the distal left main coronary artery bifurcation after treatment with a one-stent cross-over technique.
MedLine Citation:
PMID:  23008216     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To assess the geometrical changes in the distal left main coronary artery (LMCA), left anterior descending (LAD), and left circumflex (LCX) that occur after a distal LMCA lesion is treated using a onestent cross-over strategy. BACKGROUND: Morphological changes after stent implantation into distal LMCA lesions are not fully understood. METHODS: We used pre- and post-intervention three-dimensional intravascular ultrasound of both the LAD and LCX as well as of the LMCA to evaluate distal LMCA lesions after a 1-stent cross-over strategy. In 38 distal LMCA bifurcation lesions, cross-sectional measurements were performed every 1 mm over a 5 mm segment in the LAD and LCX distal to the carina and over the entire LMCA proximal to the carina. RESULTS: The increase in lumen volume correlated with the increase in external elastic membrane volumes: R=0.917, p<0.001, in the LMCA and R=0.785, p<0.001, in the LAD with no decrease in plaque volume except at the distal end of the LMCA (p=0.081) and at the LAD carina (p=0.11). The LCX lumen area decreased significantly at the LCX carina from 5.9±2.0 mm2 to 5.3±1.9 mm2 (p<0.01); however, the response was variable from a 4.0 mm2 decrease to a 1.8 mm2 increase in lumen area. While the change in LCX lumen area at the carina correlated with the change in vessel area (R=0.791, p<0.001), there was also a small increase in plaque area at the LCX carina from 6.4±2.9 mm2 to 6.8±2.9 mm2 (p<0.01). CONCLUSIONS: LMCA bifurcation lumen changes after cross-over single stent implantation were determined primarily by conformational changes in vessel geometry. © 2012 Wiley Periodicals, Inc.
Authors:
Jiancheng Xiu; So-Yeon Choi; Gary S Mintz; Hiroshi Araki; Naoki Masuda; Yoshihiro Morino; Shinjo Sonoda; Seung Jea Tahk; Masahiko Ochiai; Akiko Maehara
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-25
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
The Cardiovascular Research Foundation and Columbia University Medical Center, New York, NY.
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