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Clinical Verification of a Theory for Predicting Side Branch Stenosis after Main Vessel Stenting in Coronary Bifurcation Lesions

Clinical Verification of a Theory for Predicting Side Branch Stenosis after Main Vessel Stenting... Objectives: To verify in a clinical scenario a theory for predicting side branch (SB) stenosis after main vessel stent implantation in coronary bifurcation lesions. Background: Many unresolved issues remain regarding SB compromise when the parent vessel is stented. Methods: Bifurcation lesions (all Medina types) were subjected to angiographic analysis to determine the angle, defined as α, between the axes of the parent vessel and the SB. Using the prediction that the percent diameter stenosis (%DS) is equal to the cosine of angle α and relating it to a formula to determine the minimal lumen diameter (MLD) led to the following equation: MLD = ds · (1 –cos α); ds refers to the diameter of the SB. The predicted and observed SB stenosis values following angiography were compared. Results: Fifty‐two patients with 57 lesions were included in the analysis. Patient demographics and characteristics were similar to those in previous studies. There was a high coefficient of determination between the predicted and observed values of %DS (r2= 0.82, P < 0.001) and MLD (r2= 0.86, P < 0.001). We determined a cutoff value of 70% for predicted %DS for SB closure. When using multivariate regression analysis, the only predictor of SB ostial stenosis after stenting was α angle, whereas the predictors of MLD included the angle α and the RVD of the SB. Conclusions: Our analysis shows that the most powerful independent predictor of SB compromise is a new variable angle α. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Clinical Verification of a Theory for Predicting Side Branch Stenosis after Main Vessel Stenting in Coronary Bifurcation Lesions

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References (31)

Publisher
Wiley
Copyright
©2008, the Authors Journal compilation ©2008, Wiley Periodicals, Inc.
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/j.1540-8183.2008.00400.x
pmid
18973506
Publisher site
See Article on Publisher Site

Abstract

Objectives: To verify in a clinical scenario a theory for predicting side branch (SB) stenosis after main vessel stent implantation in coronary bifurcation lesions. Background: Many unresolved issues remain regarding SB compromise when the parent vessel is stented. Methods: Bifurcation lesions (all Medina types) were subjected to angiographic analysis to determine the angle, defined as α, between the axes of the parent vessel and the SB. Using the prediction that the percent diameter stenosis (%DS) is equal to the cosine of angle α and relating it to a formula to determine the minimal lumen diameter (MLD) led to the following equation: MLD = ds · (1 –cos α); ds refers to the diameter of the SB. The predicted and observed SB stenosis values following angiography were compared. Results: Fifty‐two patients with 57 lesions were included in the analysis. Patient demographics and characteristics were similar to those in previous studies. There was a high coefficient of determination between the predicted and observed values of %DS (r2= 0.82, P < 0.001) and MLD (r2= 0.86, P < 0.001). We determined a cutoff value of 70% for predicted %DS for SB closure. When using multivariate regression analysis, the only predictor of SB ostial stenosis after stenting was α angle, whereas the predictors of MLD included the angle α and the RVD of the SB. Conclusions: Our analysis shows that the most powerful independent predictor of SB compromise is a new variable angle α.

Journal

Journal of Interventional CardiologyWiley

Published: Dec 1, 2008

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