Interventional Cardiology Unit, San Raffaele Institute, Milan, Italy.
J Interv Cardiol. 2010 Aug;23(4):382-93. doi: 10.1111/j.1540-8183.2010.00562.x. Epub 2010 Jul 7.
Investigation of the correlation between bifurcation angles and outcomes is limited with discordant results. The aim of this study is to investigate left main (LM) and non-left main (N-LM) bifurcation angles and their modification after percutaneous coronary intervention (PCI). Measurement of all three angles adds to our understanding of bifurcation anatomy and the resultant effect of different stenting techniques.
All three bifurcation angles were described according to the European Bifurcation Club definition: the A (proximal bifurcation angle), the B (distal bifurcation angle) and the C (main branch angle). Measurements were performed in 75 LM and 140 N-LM bifurcations. In LM bifurcations baseline mean values of C, A, and B were 151 degrees +/- 28 degrees, 131 degrees +/- 32 degrees, and 78 +/- 28 degrees, respectively. In bifurcations with 2 stents the B significantly decreased by a mean of 10 degrees (P = 0.003) and A increased by 10 degrees (P = 0.006). Crush stenting significantly decreased B (A - 14 degrees ; P = 0.020) and increased A (A + 21 degrees; P = 0.005), particularly non-true bifurcations. In N-LM bifurcations mean values for C, A, and B were 156 degrees +/- 19 degrees , 144 degrees +/- 22 degrees, and 60 degrees +/- 20 degrees, respectively. Similar to LM bifurcations, the B became narrower mainly at the expense of the A, which became wider. In both types of bifurcations the greatest variation in A and B was found following 2-stent techniques performed in T-shaped (> or =70 degrees) bifurcations.
In both LM and N-LM bifurcations we found a significant difference in A and B pre- and post-PCI. This difference was driven by the 2-stent technique and was most evident with a baseline bifurcation angle > or =70 degrees. The Crush technique caused the largest angle variation post-procedure, particularly in non-true LM bifurcations.
分叉角度与结果之间的相关性研究因结果不一致而受到限制。本研究旨在探讨左主干（LM）和非左主干（N-LM）分叉角度及其经皮冠状动脉介入治疗（PCI）后的变化。三个角度的测量增加了我们对分叉解剖结构的理解，以及不同支架技术的最终效果。
根据欧洲分叉俱乐部的定义描述了所有三个分叉角度：A（近分叉角度）、B（远分叉角度）和 C（主支角度）。在 75 个 LM 和 140 个 N-LM 分叉中进行了测量。在 LM 分叉中，C、A 和 B 的基线平均值分别为 151 度 +/- 28 度、131 度 +/- 32 度和 78 +/- 28 度。在使用 2 个支架的分叉中，B 显著减小了 10 度（P = 0.003），A 增加了 10 度（P = 0.006）。Crush 支架技术显著减小了 B（A - 14 度；P = 0.020），并增加了 A（A + 21 度；P = 0.005），特别是在非真正分叉中。在 N-LM 分叉中，C、A 和 B 的平均值分别为 156 度 +/- 19 度、144 度 +/- 22 度和 60 度 +/- 20 度。与 LM 分叉相似，B 变窄主要是因为 A 变宽。在这两种类型的分叉中，在 T 形分叉（>=70 度）中进行 2 个支架技术后，A 和 B 的变化最大。
在 LM 和 N-LM 分叉中，我们发现 PCI 前后 A 和 B 有显著差异。这种差异是由 2 个支架技术驱动的，在基线分叉角度>=70 度时最为明显。Crush 技术在术后引起的角度变化最大，特别是在非真正的 LM 分叉中。
