The bifurcation study using 64 multislice computed tomography

Kawasaki, Terukazu; Koga, Hisashi; Serikawa, Takeshi; Orita, Yoshiya; Ikeda, Shinsuke; Mito, Taro; Gotou, Yoshitaka; Shintani, Yoshiaki; Tanaka, Atsushi; Tanaka, Hidenori; Fukuyama, Takeshi; Koga, Nobuhiko

doi:10.1002/ccd.21916

Cited by 44 publications

(37 citation statements)

References 14 publications

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“…Wide angles are more commonly encountered at the LMCA bifurcation. Kawasaki et al studied the coronary bifurcation angle in 209 patients, using 64 multidetector-row CT, and found that the distribution of T-type bifurcation was more frequent in the LMCA than at the LAD/diagonal bifurcation (26 vs. 8%) [27]. In prior studies, using the same 3D right angle LMCA model applied in our study, stent overlap was observed in the distal LMCA [13].…”

Section: Kissing Stentssupporting

confidence: 58%

Three‐dimensional modeling of double‐stent techniques at the left main coronary artery bifurcation using micro‐focus X‐ray computed tomography

Murasato¹,

Horiuchi²

2007

Cathet Cardio Intervent

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Section: Kissing Stentssupporting

confidence: 58%

Three‐dimensional modeling of double‐stent techniques at the left main coronary artery bifurcation using micro‐focus X‐ray computed tomography

Murasato¹,

Horiuchi²

2007

Cathet Cardio Intervent

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“…1B-E). Kawasaki et al have studied the angles of the LMCA bifurcation in 209 patients, using 64 multidetector-row computed tomography, and have found that the mean angles between LMCA and LAD, LMCA and LCX, and LAD and LCX measured 1438, 1218, and 728, respectively [20]. Since these same angles in our model measured 1358, 1358, and 908, they can be used as a surrogate for a human LMCA bifurcation.…”

Section: Discussionmentioning

confidence: 58%

Impact of three‐dimensional characteristics of the left main coronary artery bifurcation on outcome of crush stenting

Murasato¹

2007

Cathet Cardio Intervent

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Overlap of the LAD stent over, as opposed to under, the LCX stent was associated with close apposition of the stent to the vessel on the myocardial side, at the ostium of the LCX artery, where atherosclerotic plaques are likely to be present. The spatial plaque burden and bifurcation angle should be closely examined before crush stenting, and segments should not be left unstented over large plaques.

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“…It should be noted, however, that in the anatomical location of the LCx ostium, even conventional metallic stents have failed to produce consistent favorable outcomes [55]. This fact may be attributed to the acute angulation and hinge motion at the LMS-LCx junction, where a stent/scaffold is subjected to torsion, flexion and rotational forces [56,57] that may lead to stent/scaffold fatigue, fracture and subsequent restenosis or thrombosis at follow-up. This is more likely to occur in a scaffold that is dilated beyond its recommended limits or that has started to be reabsorbed, hence losing its radial strength.…”

Section: Ostial Lesionsmentioning

confidence: 99%

Bioresorbable scaffolds for the treatment of complex lesions: are we there yet?

Panoulas

Sato

Miyazaki

et al. 2015

Interventional Cardiology

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The introduction of bioresorbable vascular scaffolds (BRS) is changing the landscape of percutaneous coronary revascularization and is considered by many the 4th revolution in interventional cardiology. To date, BRS have shown promising short-and long-term results in the treatment of simple de novo lesions. Even though the feasibility, efficacy and safety of BRS implantation for more complex lesion subsets remain unknown, reports are emerging aiming to identify the role of BRS in everyday practice. In the current review we are aiming to summarize the results from 'all-comer' BRS studies and identify strengths and limitations of BRS when tackling specific complex lesion subsets. Keywords: acute coronary syndrome • bifurcation • bioresorbable scaffold • BRS • BVS • calcific • complex • left main • ostial • outcomesThe introduction of bioresorbable vascular scaffolds (BRS) is changing the landscape of percutaneous coronary revascularization and is considered by many the 4 th revolution in interventional cardiology. The emergence of drug-eluting stents (DES) and more potent antiplatelet drugs has improved patient outcomes by reducing the incidence of restenosis and stent thrombosis [1,2]. Despite improvements in the safety profile of DES [3], late lumen loss, late stent thrombosis and permanent vessel caging are bitter reminders of the inherited limitations of inserting a foreign material in the walls of the coronary arteries. BRS are the product of the attempts to overcome these limitations by temporarily providing support to the vessel wall with a scaffold that will subsequently disappear in 2-4 years' time. Even though increases in the plaque size in the first couple of years post implantation compared with their metallic counterparts have been observed, bioresorbable scaffolds compensate by facilitating plaque regression [4] and by promoting expansive remodeling [5] at long-term follow-up. Despite the positive early experience with BRS in de novo simple lesions, the efficacy and long-term behavior of BRS implanted in complex lesions remains unknown. In recent days several real-world registries have published their early experiences with BRS and will be discussed in the current review. Bioresorbable vascular scaffolds clinical studiesThe initial experience with BRS implantation in de novo simple lesions has proven remarkable. Excellent long-term outcomes (major adverse cardiovascular events 3.4%) have been demonstrated in the 5-year follow-up of the ABSORB (Bioresorbable Everolimus Eluting Vascular Scaffold) Cohort A [6] where 30 patients with single simple de novo lesions were treated with the Absorb version v1.0. From 6-months to 2-year, the luminal dimensions in vessels treated with BRS Absorb v1.0 were increased [7] due to a decrease in plaque size without change in vessel size suggestive of positive remodeling. The Absorb v1.1 [8] multi-imaging modality study revealed unchanged late luminal loss after the first year, whereas on intravascular ultrasound (IVUS), mean lumen, scaffold, plaque and vessel area show...

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The bifurcation study using 64 multislice computed tomography

Cited by 44 publications

References 14 publications

Three‐dimensional modeling of double‐stent techniques at the left main coronary artery bifurcation using micro‐focus X‐ray computed tomography

Three‐dimensional modeling of double‐stent techniques at the left main coronary artery bifurcation using micro‐focus X‐ray computed tomography

Impact of three‐dimensional characteristics of the left main coronary artery bifurcation on outcome of crush stenting

Bioresorbable scaffolds for the treatment of complex lesions: are we there yet?

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