Vulnerable Carina Anatomy and Ostial Lesions in the left Anterior Descending Coronary Artery After Floating-Stent Treatment

Carina Bifurcation Angle and Side Branch Occlusion in Coronary Bifurcation Lesions Intervention: Angiographic Lesions Characteristic Role in Determining Its Relation

“…13 Medina et al reported that an acute angulation morphology of carina (eyebrow sign) on IVUS examination is a predictor of decreased blood flow to the side branch (18 vs 1%, p < 0.01). 14 Xu et al found that the changes in blood volume associated with the shifting of carina can cause the flow changes in the side branch (r ¼ 0.94, p < 0.001). 7 Different with previous studies, this study finds that ratio of diameter between proximal segment of the main vessel and side branch segment has no effect on the occurrence of side branch occlusion.…”

Plaque morphology predictors of side branch occlusion after provisional stenting in coronary bifurcation lesion: Results of optical coherence tomography bifurcation study (ORBID)

“…Our conclusion that the presence of contralateral lipid is another independent predictor of SB stenosis is in a good agreement with the pathology observations. A spiky (“eyebrow” sign) carina appearance on IVUS and narrower carina angles by OCT have been shown to predict SB narrowing through the shift of carina towards the SB lumen . Our finding that the SBOS >50% group had smaller, however not significant carina angles might support the carina shift mechanism.…”

“…In addition, bifurcation angle by baseline angiography was associated with SB stenosis after MV stenting . Recently, several intravascular ultrasound (IVUS) studies focused on the bifurcation lesions not involving SB and established main vessel plaque shift and carina shift into the SB lumen as two main mechanisms of SB occlusion; however, no specific predictors except for “eyebrow” sign by IVUS have been established . This may be related to the inherent limitations of traditional two‐dimensional quantitative coronary angiography (QCA) in accurate assessment of bifurcation lesion, low resolution of IVUS, and inability of accurate assessment of the SB ostium area using IVUS or OCT MV pullback.…”

Percutaneous Coronary Intervention Planning and Optimization with Optical Coherence Tomography

“…Even if spared from lesion involvement, an elongated carina may cause obstruction of the side branch ostium after stent implantation in the main vessel. 48 This morphology ("spikey" or "eyebrow" carina) can be easily detected by preintervention OCT, particularly on the high-resolution longitudinal view and the 3D reconstruction (Fig. 19).…”