Document Detail


Ultrasound study of the prevalence of plaque at the carina in lesions that affect the coronary bifurcation. Implications for treatment with provisional stent.
MedLine Citation:
PMID:  21190777     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVES: The plaque distribution patterns in coronary bifurcation lesions are not well understood. It has been speculated that carina is free of plaque partly because of high wall shear stress providing an atheroprotective effect. To study plaque distribution with intravascular ultrasound (IVUS) in the coronary bifurcation and the prevalence of carina involvement.
METHODS: IVUS study was performed on 195 coronary bifurcation lesions in the main vessel (MV) and on 91 in the side branch (SB). Plaque at the carina was considered when its thickness was > 0.3mm. Plaque burden was measured at different levels: proximal reference, distal, carina and at the point of minimal lumen area (MLA).
RESULTS: The prevalence of plaque at the carina was 32%. Its thickness was 0.8 (0.36) mm, less than that observed at the counter-carina [1.22 (0.54) mm; P<.01]. The prevalence was higher (52%) when the MLA point was distal to the carina. The plaque at the carina was associated with a lower incidence of damage at the SB ostium after stenting the MV (32% vs 54%; P<.04).
CONCLUSIONS: The carina is not immune to atherosclerosis, showing plaque at this level in one third of the bifurcations. The incidence of plaque is higher in those bifurcations with the MLA point distal to the carina and seems to be associated with a lower incidence of damage to the SB ostium.
Authors:
Alfonso Medina; Pedro Martín; Javier Suárez de Lezo; José Nóvoa; Francisco Melián; Enrique Hernández; José Suárez de Lezo; Manuel Pan; Luis Burgos; Celestina Amador; Oscar Morera; Antonio García
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Publication Detail:
Type:  Journal Article     Date:  2010-12-17
Journal Detail:
Title:  Revista española de cardiología     Volume:  64     ISSN:  1579-2242     ISO Abbreviation:  Rev Esp Cardiol     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404277     Medline TA:  Rev Esp Cardiol     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  43-50     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
Affiliation:
Servicio de Cardiología, Hospital Universitario de Gran Canaria Doctor Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
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