An investigation of correlation between left coronary bifurcation angle and hemodynamic changes in coronary stenosis by coronary computed tomography angiography-derived computational fluid dynamics

Abstract

This study further clarifies the relationship between left coronary bifurcation angle and significant stenosis, with angulation measurement serving as a more accurate approach than coronary lumen assessment or plaque lesion length for determining significant coronary stenosis. Left coronary bifurcation angle is suggested to be incorporated into coronary artery disease (CAD) assessment when diagnosing significant CAD.

3D printing in medicine: current applications and future directions

“…Technical developments in medical imaging techniques have led to significant improvements in the diagnostic performance of less-invasive imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine and ultrasound. Quantitative analysis of these imaging modalities allows for detection and diagnosis of various diseases with high accuracy (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Despite promising results available in the literature, traditional two-dimensional (2D) and three-dimensional (3D) visualization tools are still limited to a 2D screen, which affect realistic visualization of anatomical structures and pathologies of 3D datasets, and this is particularly apparent when dealing with complex pathologies.…”

Evaluation of the Relationship between Left Coronary Artery Bifurcation Angle and Coronary Artery Disease: A Systematic Review

“…Seven of the thirteen studies were causal-comparative by design [ 4 , 6 , 7 , 8 , 15 , 16 , 17 ], five were descriptive [ 9 , 10 , 11 , 12 , 18 ], and one study had both causal-comparative and correlational components [ 19 ] ( Table 2 ). Five of the thirteen studies (38%) were conducted in Australia [ 4 , 6 , 10 , 11 , 16 ], three (22%) in China [ 8 , 9 , 12 ], one (8%) in Taiwan [ 7 ], one (8%) in Turkey [ 19 ], one (8%) in South Korea [ 15 ], one (8%) in Argentina [ 17 ], and one (8%) was a collaborative study between authors from Saudi Arabia, India, and Oman [ 18 ].…”

“…Seven of the thirteen studies were causal-comparative by design [ 4 , 6 , 7 , 8 , 15 , 16 , 17 ], five were descriptive [ 9 , 10 , 11 , 12 , 18 ], and one study had both causal-comparative and correlational components [ 19 ] ( Table 2 ). Five of the thirteen studies (38%) were conducted in Australia [ 4 , 6 , 10 , 11 , 16 ], three (22%) in China [ 8 , 9 , 12 ], one (8%) in Taiwan [ 7 ], one (8%) in Turkey [ 19 ], one (8%) in South Korea [ 15 ], one (8%) in Argentina [ 17 ], and one (8%) was a collaborative study between authors from Saudi Arabia, India, and Oman [ 18 ]. Five studies (38%) involved the use of CFD analysis to observe and measure intraluminal forces at the LAD-LCx angle [ 9 , 10 , 11 , 12 , 18 ], and eight (62%) involved repeatedly measuring LAD-LCx angle on coronary angiography imaging to assess its relationship with CAD and/or associated risk factors [ 4 , 6 , 7 , 8 , 15 , 16 , 17 , 19 ].…”

“…Five of the thirteen studies (38%) were conducted in Australia [ 4 , 6 , 10 , 11 , 16 ], three (22%) in China [ 8 , 9 , 12 ], one (8%) in Taiwan [ 7 ], one (8%) in Turkey [ 19 ], one (8%) in South Korea [ 15 ], one (8%) in Argentina [ 17 ], and one (8%) was a collaborative study between authors from Saudi Arabia, India, and Oman [ 18 ]. Five studies (38%) involved the use of CFD analysis to observe and measure intraluminal forces at the LAD-LCx angle [ 9 , 10 , 11 , 12 , 18 ], and eight (62%) involved repeatedly measuring LAD-LCx angle on coronary angiography imaging to assess its relationship with CAD and/or associated risk factors [ 4 , 6 , 7 , 8 , 15 , 16 , 17 , 19 ]. Of the studies analysing CFD, one used models derived from real patients’ CCTA datasets [ 10 ], two used simulated LAD-LCx models [ 12 , 18 ], and two used a combination of both [ 9 , 11 ], with sample sizes ranging from four to 30 models [ 9 , 10 , 18 ].…”

“…The findings of several recent studies have suggested a direct correlation between LAD-LCx bifurcation angle and CAD [ 4 , 6 , 7 , 8 ]. This has been investigated further via computational fluid dynamics (CFD), with the correlation being primarily attributed to a change in wall shear stress (WSS) observed in bifurcation angles of variable size [ 9 , 10 , 11 , 12 ]. Consequently, it has been proposed that the LAD-LCx angle may be indicative of a patient’s likelihood of developing CAD, and it could be a useful tool for enhancing the routine diagnostic reporting of coronary computed tomography angiography (CCTA) studies [ 4 , 13 ], especially since the LAD-LCx measurement is of improved diagnostic value compared to standard coronary lumen assessment [ 6 ].…”