A computational atlas of normal coronary artery anatomy

Medrano-Gracia, Pau; Ormiston, John A.; Webster, Mark; Beier, Susann; Young, Alistair A.; Ellis, Chris; Wang, Chunliang; Smedby, Örjan; Cowan, Brett R.

doi:10.4244/eijv12i7a139

Cited by 49 publications

(32 citation statements)

References 20 publications

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“…Mean "reference" diameter, derived from a large intravascular ultrasound (IVUS) study 3 , is 5 mm, and ranges between 3.5 and 6.5 mm. After a mean length of 10.5±5.3 mm 4 , the LM divides into the left anterior descending artery (LAD) and the left circumflex artery (LCX). In up to 25% of cases, a distal trifurcation exists due to the presence of an intermediate branch.…”

Section: Left Main Stem Anatomymentioning

confidence: 99%

“…In up to 25% of cases, a distal trifurcation exists due to the presence of an intermediate branch. Importantly, the size of the normal LM and its bifurcation into the LAD and LCX is predictable using fractal geometry and Finet's law 4 . Although being variably oriented in the three dimensions, LM bifurcation geometry is often summarised according to the distal bifurcation angle (also called angle B) which is highly variable but often wide (higher than other coronary bifurcations), with a mean estimated value of 70-80° 4 .…”

Section: Left Main Stem Anatomymentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous coronary intervention in left main coronary artery disease: the 13th consensus document from the European Bifurcation Club

Burzotta¹,

Lassen²,

Banning³

et al. 2018

EuroIntervention

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The 2017 European Bifurcation Club (EBC) meeting was held in Porto (Portugal) and allowed a multidisciplinary international faculty to review and discuss the latest data collected in the field of coronary bifurcation interventions. In particular, the topic of percutaneous coronary intervention (PCI) on left main coronary artery (LM) disease was highlighted as a contemporary priority. Herein, we summarise the key LM anatomy features, the diagnostic modalities and available data that are relevant for a patient's procedural management. Since the clinical outcomes of patients undergoing PCI on LM disease may depend on both PCI team organisation and PCI performance, the optimal catheterisation laboratory set-up and the rationales for device and technique selection are critically reviewed. The best lesion preparation modalities, the different DES implantation technique choices and the strategies to be considered during PCI on unprotected LM for optimal PCI results are reviewed step by step.

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Section: Left Main Stem Anatomymentioning

confidence: 99%

Section: Left Main Stem Anatomymentioning

confidence: 99%

Percutaneous coronary intervention in left main coronary artery disease: the 13th consensus document from the European Bifurcation Club

Burzotta¹,

Lassen²,

Banning³

et al. 2018

EuroIntervention

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“…Traditional clinical approaches to the quantification of vascular bifurcation shape focus almost entirely on simple geometric parameters such as diameter and angle, with their averages determined independently within various populations [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 ]). Previously, we published selected basic measures such as angles and diameters [ 7 ], and we investigated the use of centrelines and cross-sectional shape data to create an average coronary artery model using tree-spaces [ 8 ]. In this work, we present a robust methodology to register any computer-aided design (CAD) to a correspondenceless population of shapes, and apply it to build a large expert-reviewed fully 3D atlas of vessel bifurcations.…”

Section: Introductionmentioning

confidence: 99%

A Study of Coronary Bifurcation Shape in a Normal Population

Medrano-Gracia

Ormiston

Webster

et al. 2016

J. of Cardiovasc. Trans. Res.

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During percutaneous coronary intervention, stents are placed in narrowings of the arteries to restore normal blood flow. Despite improvements in stent design, deployment techniques and drug-eluting coatings, restenosis and stent thrombosis remain a significant problem. Population stent design based on statistical shape analysis may improve clinical outcomes. Computed tomographic (CT) coronary angiography scans from 211 patients with a zero calcium score, no stenoses and no intermediate artery, were used to create statistical shape models of 446 major coronary artery bifurcations (left main, first diagonal and obtuse marginal and right coronary crux). Coherent point drift was used for registration. Principal component analysis shape scores were tested against clinical risk factors, quantifying the importance of recognised shape features in intervention including size, angles and curvature. Significant differences were found in (1) vessel size and bifurcation angle between the left main and other bifurcations; (2) inlet and curvature angle between the right coronary crux and other bifurcations; and (3) size and bifurcation angle by sex. Hypertension, smoking history and diabetes did not appear to have an association with shape. Physiological diameter laws were compared, with the Huo-Kassab model having the best fit. Bifurcation coronary anatomy can be partitioned into clinically meaningful modes of variation showing significant shape differences. A computational atlas of normal coronary bifurcation shape, where disease is common, may aid in the design of new stents and deployment techniques, by providing data for bench-top testing and computational modelling of blood flow and vessel wall mechanics.Electronic Supplementary MaterialThe online version of this article (doi:10.1007/s12265-016-9720-2) contains supplementary material, which is available to authorized users.

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“…Let us consider a vessel with a diameter d 0 , which splits into two branches with diameters d 1 and d 2 (Fig. 1), then according to Murray's law Experimental studies have shown that Murray's law is also true for tubules of some leaves [2], but more accurate measurements showed deviations from Murray's law in the vascular system [3][4][5][6][7]. These tests were performed using CT (computed tomography), IVUS (intravascular ultrasound), direct post mortem measurements, etc.…”

Section: Introductionmentioning

confidence: 99%

Finet’s Law as a Special Case of the Generalised Murray’s Law

Zieliński

Nowosielski

2019

SN COMPUT. SCI.

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A thorough knowledge of statistical properties of the coronary artery tree is very important in cardiology. We present generalised form of Murray's law-the first law that described the relationship between vessel diameters in bifurcation. We show that other frequently used laws: Huo-Kassab and Finet's rules are the special cases of its generalised form. We show theoretically that the Finet's law is met with an apparently paradoxical relationship between the lengths and diameters of the vessels. Based on the analysis of CT 3D scans, we show that in the left coronary artery the diameters and lengths of vessels are inversely proportional which explains the applicability of the Finet's law. We justify theoretically the value of coefficient defining Finet's law.

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A computational atlas of normal coronary artery anatomy

Cited by 49 publications

References 20 publications

Percutaneous coronary intervention in left main coronary artery disease: the 13th consensus document from the European Bifurcation Club

Percutaneous coronary intervention in left main coronary artery disease: the 13th consensus document from the European Bifurcation Club

A Study of Coronary Bifurcation Shape in a Normal Population

Finet’s Law as a Special Case of the Generalised Murray’s Law

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