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MV to SB transition zone in human coronaries: Unique geometric insights missed by QCA

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MV to SB transition zone in human coronaries: Unique geometric insights missed by QCA

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

 

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