How Much Does the Left Main Bifurcation Angle Change Throughout the Cardiac Cycle? Quantitative Implications for Left Main Bifurcation Stent Designs

Handran, Chauncy B.; Lesser, John R.; Henry, Timothy D.; Gilmore, Michael E.; Wickstrom, Kelly; Schwartz, Robert S.

doi:10.1016/s0735-1097(11)61656-2

Cited by 3 publications

(4 citation statements)

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“…Additionally, we demonstrated that LAD-LCX increases in 49 (24.4%) patients and LMCA-LCX angle decreases in 55 (27.4%) patients due to systolic motion. These findings are also consistent with recently published study by Handran et al [14]. Additionally, we found that DSR of LAD-LCX angle was ≥ 10° in 48.8% and < 10° in 51.2% of the patients.…”

Section: Discussionsupporting

confidence: 94%

Anatomic assessment of the left main bifurcation and dynamic bifurcation angles using computed tomography angiography

et al. 2017

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Section: Discussionsupporting

confidence: 94%

Anatomic assessment of the left main bifurcation and dynamic bifurcation angles using computed tomography angiography

et al. 2017

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“…A narrower Angle A in the LMCA in patients with chronic kidney disease was likely to present with more calcified lesions [ 20 ]. Another CCTA study revealed that angle change due to the cardiac motion was more prominent in the Angle A (LMCA-LCX angle) compared to the Angle C (LMCA-LAD angle) [ 33 ].…”

Section: Review and Discussionmentioning

confidence: 99%

“…1.3 Cardiac computed tomography angiography (CCTA) (Table 1). CCTA provides additional 3D information on the bifurcated area and accurate BA measurement in an optimal view [32][33][34][35]. According to the CCTA studies which included >200 patients without significant coronary stenosis [32,34], the average LMCA BAs (Angle A: LMCA-LCX, Angle B: LAD-LCX, Angle C: LMCA-LAD) were 126-143˚, 72-79˚, and 121-139˚, respectively [32,34,35].…”

Section: Plos Onementioning

confidence: 99%

Impact of coronary bifurcation angle on the pathogenesis of atherosclerosis and clinical outcome of coronary bifurcation intervention–A scoping review

et al. 2022

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Background A coronary bifurcation stenting is still a challenging issue due to frequent restenosis and stent thrombosis even with drug-eluting stents. The bifurcation angle (BA) between a main vessel and a side branch is one of the crucial determinants of coronary flow and shear stress that affect the plaque distribution. Previous bench and clinical studies have evaluated the impact of the BA between the proximal main vessel and the side branch (Angle A) and the BA between the distal main vessel and the side branch (Angle B) on the clinical outcomes of bifurcation stenting. However, the impact has not yet been fully elucidated due to a lack of statistical power or different manner of the assessment of BA. Objectives To analyze the published studies on coronary artery BA, the modalities used for assessment, and the impact of BA on interventions and attempt to define the pre-procedural protocols. Data sources A scoping review was performed using the Joanna Briggs Institute Methodology. A total of 52 relevant references were selected from PubMed, Cochrane Library, and CINAHL databases and categorized into three topic areas. Results and conclusions A wider Angle A is associated with the increased likelihood of carina shift and a wider Angle B, with that of side branch occlusion. A wider Angle B promotes stent malapposition and deformation in the side branch ostium and has been reported as an independent predictor of major adverse cardiac events after bifurcation stenting; however, improvement of the drug-eluting stent, refinement of the stenting technique, and accurate 3-dimensional assessment may attenuate the adverse clinical impact of a wider BA. Implications of key findings Assessment of the BA is necessary to predict the effect of bifurcation intervention procedure on the stent configuration and coronary flow at the bifurcated vessels. This will help to optimize stent selection and the stenting technique.

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“…Larger bifurcation angles were found to correlate with the growth of plaque buildup and is proposed as a biomarker for predicting the risk of CAD [13]. Accurate assessment of the bifurcation angle is also essential in design optimization and implementation of coronary stents, which consequently reduces restenosis and stent thrombosis, leading to improved outcome for patients undergoing interventional treatment of the atherosclerosis [14][15][16][17].…”

Section: 'Introductionmentioning

confidence: 99%

Measurement of coronary bifurcation angle with coronary CT angiography: A phantom study

et al. 2018

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How Much Does the Left Main Bifurcation Angle Change Throughout the Cardiac Cycle? Quantitative Implications for Left Main Bifurcation Stent Designs

Cited by 3 publications

References 0 publications

Anatomic assessment of the left main bifurcation and dynamic bifurcation angles using computed tomography angiography

Anatomic assessment of the left main bifurcation and dynamic bifurcation angles using computed tomography angiography

Impact of coronary bifurcation angle on the pathogenesis of atherosclerosis and clinical outcome of coronary bifurcation intervention–A scoping review

Measurement of coronary bifurcation angle with coronary CT angiography: A phantom study

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