EBC - ON DEMAND
European Bifurcation Club 2007, EBC 2007 – Valencia, Spain
QCA OF BIFURCATION LESIONS
MV to SB transition zone in human coronaries: Unique geometric insights missed by QCA
Author: Mary E. Russell, MD, FACC, Ascent Translational Sciences Carlisle, Massachusetts, USA
PROGRAM OBJECTIVES
- Define bifurcation anatomy and geometry
- Casts of human coronary tree to evaluate intersection between Main Vessel (MV) & Side Branch (SB)
- Qualitative assessments
- Quantitative measures
SUMMARY
- Bifurcation diameters (~ to previous reports)
- MV: Wide Range (1.7 to 4.2),
- SB: Wide Range (1.6 to 2.6), mean 2.28
- Fours Types of Asymmetric Ostial Geometry:
- Multifaceted transition (high magnification detail)
- Oval rather than round ostium
- Taper with SB 3-fold greater than MB
- Side branch take off angles
CONCLUSION – Distort stent or Distort anatomy?
- Complex transition zone from the MV to SB up to 4 asymmetric features
- Anatomic distortion likely with symmetric (cylindrical) designs
- Matching design to asymmetric ostial geometry may minimize implant injury, enhance scaffolding and improve outcomes