Abstract 9908: Three-dimensional Optical Coherence Tomographic Analysis of Eccentric Morphology of the Jailed Side-branch Ostium in Coronary Bifurcation Lesions
Introduction: Using the 3D-OCT, morphologic changes in the jailed side- branch ostium were evaluated before and after a single stent crossover at coronary bifurcation lesions.
Hypothesis: The severity of angiographic diameter stenosis of the jailed side-branch ostium is usually overestimated over the three-dimensional (3D) optical coherence tomography (OCT)-measured actual stenosis.
Methods: In 109 patients who received a single stent crossover at coronary bifurcation lesions, the pre- and post-intervention minimal lumen area (MLA) and the eccentricity of the jailed side-branch ostium were measured with 3D-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 3D-OCT-measured MLA of the jailed side-branch ostium decreased from 2.91±1.65 mm2 pre-intervention to 2.37±1.48 mm2 post-intervention (p<0.01). The QCA- derived MLA also decreased from 2.35±1.71 mm2 pre-intervention to 1.68±1.56 mm2 post- intervention (p<0.01). However, the 3D-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 pre- intervention; 1.71±0.60 post-intervention, p<0.01).
Conclusions: Compared to QCA measurements, 3D-OCT analysis could be useful to guide decision for additional intervention or not after stent implantation across coronary bifurcation lesions.
Author Disclosures: S. Cho: None. J. Kim: None. J. Ha: None. D. Shin: None. B. Kim: None. Y. Ko: None. D. Choi: None. Y. Jang: None. M. Hong: None.
- © 2015 by American Heart Association, Inc.