Three-Dimensional Optical Coherence Tomographic Analysis of Eccentric Morphology of the Jailed Side-Branch Ostium in Coronary Bifurcation Lesions

Sungsoo Cho, Jung Sun Kim, Jinyong Ha, Dong Ho Shin, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong

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Abstract

Background: The severity of angiographic diameter stenosis of the jailed side-branch ostium is usually overestimated over the 3-D optical coherence tomography (OCT)-measured actual stenosis. Using 3-D OCT, morphologic changes in the jailed side-branch ostium were evaluated before and after a single stent crossover at coronary bifurcation lesions. Methods: In 109 patients who received a single stent crossover at coronary bifurcation lesions, the minimal lumen area (MLA) before and after intervention and the eccentricity of the jailed side-branch ostium were measured with 3-D OCT. The eccentricity index was defined as the ratio of maximal diameter/minimal diameter of the jailed side-branch ostium. When the eccentricity index was < 1.5, the shape of the jailed side-branch ostium was defined as circular. The MLA of the jailed side-branch ostium was also calculated from the quantitative coronary angiography (QCA) minimal lumen diameter assuming a circular lumen. Results: The 3-D OCT-measured MLA of the jailed side-branch ostium decreased from 2.91 ± 1.65 mm2 before intervention to 2.37 ± 1.48 mm2 after intervention (P < 0.01). The QCA-derived MLA also decreased from 2.35 ± 1.71 mm2 before intervention to 1.68 ± 1.56 mm2 after intervention (P < 0.01). However, the 3-D OCT-measured MLA was significantly larger than the QCA-derived MLA (P < 0.01). The shape of the jailed side-branch ostium changed from circular to elliptical after the stent implantation (eccentricity index: 1.40 ± 0.33 before intervention; 1.71 ± 0.60 after intervention; P < 0.01). Conclusions: Compared with QCA measurements, 3-D OCT analysis could be useful to guide decisions regarding additional intervention after stent implantation across coronary bifurcation lesions.

Original languageEnglish
Pages (from-to)234-239
Number of pages6
JournalCanadian Journal of Cardiology
Volume32
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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