Eccentric morphology of jailed side-branch ostium after stent crossover in coronary bifurcation lesions: A three-dimensional optical coherence tomographic analysis

Pil Sung Yang, Jinyong Ha, Jung Sun Kim, Seungsu Park, Jinju Bae, Dong Ho Shin, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong

Research output: Contribution to journalArticle

9 Citations (Scopus)

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±1.22mm2 pre-intervention to 0.84±0.91mm2 post-intervention, p<0.001). However, the MLA of jailed side-branch ostium measured at post-intervention by 3D-OCT (2.67±1.75mm2) 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±1.50mm2 at 3-6 months post-intervention; 2.44±1.27mm2 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.

Original languageEnglish
Pages (from-to)305-310
Number of pages6
JournalJournal of Cardiology
Volume65
Issue number4
DOIs
Publication statusPublished - 2015 Apr 1

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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