Division of Cardiology, Gumi CHA University Medical Center, Gumi, Korea.
Yonsei Med J. 2012 Jul 1;53(4):680-4. doi: 10.3349/ymj.2012.53.4.680.
Accurate evaluation of side branch (SB) ostium could be critical to the treatment of bifurcation lesions. We compared measured and calculated values of side branch ostial length (SBOL) in coronary bifurcation lesions with intravascular ultrasound (IVUS).
Pre-intervention and post-intervention IVUS was performed in 113 patients who underwent stent implantation of bifurcation lesions. For the IVUS longitudinal reconstruction of the bifurcation lesions, SBOL, SB diameter, and the angle between the distal portion of the main vessel (MV) and SB were directly measured. In addition, SBOL was calculated as: SB diameter/ sin (angle between distal MV and SB). The relationship between measured and calculated SBOL was then evaluated.
The angled between the distal MV and SB were 57.3±12.4° at pre-intervention and 59.4±12.6° at post-intervention. The mean measured and calculated SBOL values were 2.91±0.86 mm and 3.06±0.77 mm at pre-intervention and 2.79±0.82 mm and 2.92±0.69 mm at post-intervention, respectively. Differences between measured and calculated SBOL were 0.15±0.44 mm at pre-intervention and 0.13±0.41 mm at post-intervention. We found that calculated SBOL was correlated with measured SBOL (pre-intervention r=0.863, p<0.001; post-intervention r=0.868, p<0.001).
There was a good correlation between measured and calculated SBOLs of the bifurcation lesions in IVUS longitudinal reconstruction. SBOL in the bifurcation lesions can therefore be estimated using the SB diameter and the angle between distal MV and SB.
准确评估边支(SB)开口对于分叉病变的治疗至关重要。我们比较了冠状动脉分叉病变血管内超声(IVUS)测量和计算的边支开口长度(SBOL)值。
113 例接受分叉病变支架植入术的患者进行了介入前和介入后 IVUS 检查。对于分叉病变的 IVUS 纵向重建,直接测量 SBOL、SB 直径和主血管(MV)远端与 SB 之间的夹角。此外,还通过 SB 直径/sin(MV 远端与 SB 之间的夹角)计算 SBOL。然后评估测量和计算的 SBOL 之间的关系。
介入前 MV 远端与 SB 之间的夹角为 57.3±12.4°,介入后为 59.4±12.6°。介入前和介入后测量和计算的 SBOL 平均值分别为 2.91±0.86mm 和 3.06±0.77mm,2.79±0.82mm 和 2.92±0.69mm。介入前和介入后测量的 SBOL 与计算的 SBOL 之间的差异分别为 0.15±0.44mm 和 0.13±0.41mm。我们发现计算的 SBOL 与测量的 SBOL 相关(介入前 r=0.863,p<0.001;介入后 r=0.868,p<0.001)。
IVUS 纵向重建中分叉病变的测量和计算的 SBOL 之间存在良好的相关性。因此,分叉病变的 SBOL 可以通过 SB 直径和 MV 远端与 SB 之间的夹角来估计。