Abstract 10187: Relation Between Clinical and Anatomic Factors and the Left Main Bifurcation Angle: A 3-Dimensional Coronary Angiographic Study
Objectives: Percutaneous intervention of the left main coronary artery (LM) is a therapeutic option in selected patients with coronary artery disease (CAD). The LM bifurcation angle (BA) is a determinant of procedural success and clinical outcome. However, the associations between anatomic and clinical factors and LM BA are unknown. We assessed these associations using 3D QCA software.
Methods: The LM anatomy was evaluated from angiograms of 203 pts (age=66±11 yrs, 31% female) with and without LM CAD using a 3D QCA software (IC-PRO, Paieon, Israel). LM size as well as the proximal BA (between LM and LCX) and the distal BA (between LAD and LCX) were computed in end-diastole. Pts angiographic and clinical findings were also recorded.
Results: 133/203 pts (65%) had no LM CAD. Among the 70 pts with LM CAD, 44 had distal LM disease. Univariate associates of the LM BA are presented in table. Importantly, pts with distal LM CAD had narrower proximal BA and wider distal BA (table). Multivariate analysis (adjusted for clinical and anatomic variables) identified female sex (p=0.02), trifurcation anatomy (p=0.009), age>75 yrs (p=0.0009) and LM length>12mm (p=0.001) as independent associates of proximal BA. Independent associates of the distal BA were: trifurcation anatomy (p=0.001), LM length>12mm (p<0.0001), age>75 yrs (p=0.004), and a history of CABG (p=0.04).
Conclusions: 1. The LM BA differ between pts with and without distal LM CAD. 2. Both anatomic and clinical factors may affect the LM BA. 3. On line 3D analysis of the LM BA may be useful in planning the interventional strategy.
- Coronary circulation
- Cardiovascular imaging
- Coronary artery disease
- Interventional cardiology
- © 2010 by American Heart Association, Inc.