Eccentric morphology of jailed side-branch ostium after stent crossover in coronary bifurcation lesions: A three-dimensional optical coherence tomographic analysis

Pil Sung Yang; Jinyong Ha; Jung Sun Kim; Seungsu Park; Jinju Bae; Dong Ho Shin; Byeong Keuk Kim; Young Guk Ko; Donghoon Choi; Yangsoo Jang; Myeong Ki Hong

doi:10.1016/j.jjcc.2014.12.004

Eccentric morphology of jailed side-branch ostium after stent crossover in coronary bifurcation lesions: A three-dimensional optical coherence tomographic analysis

Pil Sung Yang, Jinyong Ha, Jung Sun Kim, Seungsu Park, Jinju Bae, Dong Ho Shin, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

Abstract

Background: Angiographic stenosis of a jailed side-branch ostium is usually observed after a single-stent crossover at coronary bifurcation lesions. However, the stenosis severity is typically overestimated due to the limited information obtained from two-dimensional morphology by angiography. We evaluated the actual stenosis of jailed side-branch ostium using three-dimensional (3D) optical coherence tomography (OCT). Methods: Using 3D reconstructions of OCT data, we analyzed minimal lumen area (MLA) and eccentricity of the jailed side-branch ostium in 41 patients who were treated with single stent crossover at coronary bifurcation lesions and subsequently underwent serial OCT follow-up. Results: The MLA of jailed side-branch ostium calculated from quantitative coronary angiography (QCA) assuming a circular lumen markedly decreased after stent implantation (1.73±1.22mm² pre-intervention to 0.84±0.91mm² post-intervention, p<0.001). However, the MLA of jailed side-branch ostium measured at post-intervention by 3D-OCT (2.67±1.75mm²) was significantly larger than that measured by QCA (p<0.001). There were no statistically significant changes in MLA of jailed side-branch ostium based on 3D-OCT measurements during the follow-up (2.35±1.50mm² at 3-6 months post-intervention; 2.44±1.27mm² at 1-2 years post-intervention, p=0.098). The shapes of the jailed side-branch ostium were nearly elliptical (mean eccentricity index: 2.97±1.27 post-intervention; 2.79±1.17 at 3-6 months post-intervention; 2.59±1.02 at 1-2 years post-intervention). Conclusions: Compared to 3D-OCT measurements, QCA measurements overestimated the jailed side-branch ostial stenosis after single stent crossover due to eccentric morphology from orthogonal projection in coronary angiography. Significant changes in the MLA of jailed side-branch ostium by 3D-OCT were not observed during the follow-up.

Original language	English
Pages (from-to)	305-310
Number of pages	6
Journal	Journal of Cardiology
Volume	65
Issue number	4
DOIs	https://doi.org/10.1016/j.jjcc.2014.12.004
Publication status	Published - 2015 Apr 1

Bibliographical note

Funding Information:
This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health, Welfare & Family Affairs , Republic of Korea (No. A085012 and A102064 ), a grant from the Korea Health 21 R&D Project, Ministry of Health and Welfare , Republic of Korea (No. A085136 ), and from the Cardiovascular Research Center, Seoul, Korea.

Publisher Copyright:
© 2015 Japanese College of Cardiology.

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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10.1016/j.jjcc.2014.12.004

Cite this

Yang, P. S., Ha, J., Kim, J. S., Park, S., Bae, J., Shin, D. H., Kim, B. K., Ko, Y. G., Choi, D., Jang, Y., & Hong, M. K. (2015). Eccentric morphology of jailed side-branch ostium after stent crossover in coronary bifurcation lesions: A three-dimensional optical coherence tomographic analysis. Journal of Cardiology, 65(4), 305-310. https://doi.org/10.1016/j.jjcc.2014.12.004

@article{b68880d339594110b03db7780390eae5,

title = "Eccentric morphology of jailed side-branch ostium after stent crossover in coronary bifurcation lesions: A three-dimensional optical coherence tomographic analysis",

abstract = "Background: Angiographic stenosis of a jailed side-branch ostium is usually observed after a single-stent crossover at coronary bifurcation lesions. However, the stenosis severity is typically overestimated due to the limited information obtained from two-dimensional morphology by angiography. We evaluated the actual stenosis of jailed side-branch ostium using three-dimensional (3D) optical coherence tomography (OCT). Methods: Using 3D reconstructions of OCT data, we analyzed minimal lumen area (MLA) and eccentricity of the jailed side-branch ostium in 41 patients who were treated with single stent crossover at coronary bifurcation lesions and subsequently underwent serial OCT follow-up. Results: The MLA of jailed side-branch ostium calculated from quantitative coronary angiography (QCA) assuming a circular lumen markedly decreased after stent implantation (1.73±1.22mm2 pre-intervention to 0.84±0.91mm2 post-intervention, p<0.001). However, the MLA of jailed side-branch ostium measured at post-intervention by 3D-OCT (2.67±1.75mm2) was significantly larger than that measured by QCA (p<0.001). There were no statistically significant changes in MLA of jailed side-branch ostium based on 3D-OCT measurements during the follow-up (2.35±1.50mm2 at 3-6 months post-intervention; 2.44±1.27mm2 at 1-2 years post-intervention, p=0.098). The shapes of the jailed side-branch ostium were nearly elliptical (mean eccentricity index: 2.97±1.27 post-intervention; 2.79±1.17 at 3-6 months post-intervention; 2.59±1.02 at 1-2 years post-intervention). Conclusions: Compared to 3D-OCT measurements, QCA measurements overestimated the jailed side-branch ostial stenosis after single stent crossover due to eccentric morphology from orthogonal projection in coronary angiography. Significant changes in the MLA of jailed side-branch ostium by 3D-OCT were not observed during the follow-up.",

author = "Yang, {Pil Sung} and Jinyong Ha and Kim, {Jung Sun} and Seungsu Park and Jinju Bae and Shin, {Dong Ho} and Kim, {Byeong Keuk} and Ko, {Young Guk} and Donghoon Choi and Yangsoo Jang and Hong, {Myeong Ki}",

note = "Funding Information: This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health, Welfare & Family Affairs , Republic of Korea (No. A085012 and A102064 ), a grant from the Korea Health 21 R&D Project, Ministry of Health and Welfare , Republic of Korea (No. A085136 ), and from the Cardiovascular Research Center, Seoul, Korea. Publisher Copyright: {\textcopyright} 2015 Japanese College of Cardiology.",

year = "2015",

month = apr,

day = "1",

doi = "10.1016/j.jjcc.2014.12.004",

language = "English",

volume = "65",

pages = "305--310",

journal = "Journal of Cardiology",

issn = "0914-5087",

number = "4",

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TY - JOUR

T1 - Eccentric morphology of jailed side-branch ostium after stent crossover in coronary bifurcation lesions

T2 - A three-dimensional optical coherence tomographic analysis

AU - Yang, Pil Sung

AU - Ha, Jinyong

AU - Kim, Jung Sun

AU - Park, Seungsu

AU - Bae, Jinju

AU - Shin, Dong Ho

AU - Kim, Byeong Keuk

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Hong, Myeong Ki

N1 - Funding Information: This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health, Welfare & Family Affairs , Republic of Korea (No. A085012 and A102064 ), a grant from the Korea Health 21 R&D Project, Ministry of Health and Welfare , Republic of Korea (No. A085136 ), and from the Cardiovascular Research Center, Seoul, Korea. Publisher Copyright: © 2015 Japanese College of Cardiology.

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Background: Angiographic stenosis of a jailed side-branch ostium is usually observed after a single-stent crossover at coronary bifurcation lesions. However, the stenosis severity is typically overestimated due to the limited information obtained from two-dimensional morphology by angiography. We evaluated the actual stenosis of jailed side-branch ostium using three-dimensional (3D) optical coherence tomography (OCT). Methods: Using 3D reconstructions of OCT data, we analyzed minimal lumen area (MLA) and eccentricity of the jailed side-branch ostium in 41 patients who were treated with single stent crossover at coronary bifurcation lesions and subsequently underwent serial OCT follow-up. Results: The MLA of jailed side-branch ostium calculated from quantitative coronary angiography (QCA) assuming a circular lumen markedly decreased after stent implantation (1.73±1.22mm2 pre-intervention to 0.84±0.91mm2 post-intervention, p<0.001). However, the MLA of jailed side-branch ostium measured at post-intervention by 3D-OCT (2.67±1.75mm2) was significantly larger than that measured by QCA (p<0.001). There were no statistically significant changes in MLA of jailed side-branch ostium based on 3D-OCT measurements during the follow-up (2.35±1.50mm2 at 3-6 months post-intervention; 2.44±1.27mm2 at 1-2 years post-intervention, p=0.098). The shapes of the jailed side-branch ostium were nearly elliptical (mean eccentricity index: 2.97±1.27 post-intervention; 2.79±1.17 at 3-6 months post-intervention; 2.59±1.02 at 1-2 years post-intervention). Conclusions: Compared to 3D-OCT measurements, QCA measurements overestimated the jailed side-branch ostial stenosis after single stent crossover due to eccentric morphology from orthogonal projection in coronary angiography. Significant changes in the MLA of jailed side-branch ostium by 3D-OCT were not observed during the follow-up.

AB - Background: Angiographic stenosis of a jailed side-branch ostium is usually observed after a single-stent crossover at coronary bifurcation lesions. However, the stenosis severity is typically overestimated due to the limited information obtained from two-dimensional morphology by angiography. We evaluated the actual stenosis of jailed side-branch ostium using three-dimensional (3D) optical coherence tomography (OCT). Methods: Using 3D reconstructions of OCT data, we analyzed minimal lumen area (MLA) and eccentricity of the jailed side-branch ostium in 41 patients who were treated with single stent crossover at coronary bifurcation lesions and subsequently underwent serial OCT follow-up. Results: The MLA of jailed side-branch ostium calculated from quantitative coronary angiography (QCA) assuming a circular lumen markedly decreased after stent implantation (1.73±1.22mm2 pre-intervention to 0.84±0.91mm2 post-intervention, p<0.001). However, the MLA of jailed side-branch ostium measured at post-intervention by 3D-OCT (2.67±1.75mm2) was significantly larger than that measured by QCA (p<0.001). There were no statistically significant changes in MLA of jailed side-branch ostium based on 3D-OCT measurements during the follow-up (2.35±1.50mm2 at 3-6 months post-intervention; 2.44±1.27mm2 at 1-2 years post-intervention, p=0.098). The shapes of the jailed side-branch ostium were nearly elliptical (mean eccentricity index: 2.97±1.27 post-intervention; 2.79±1.17 at 3-6 months post-intervention; 2.59±1.02 at 1-2 years post-intervention). Conclusions: Compared to 3D-OCT measurements, QCA measurements overestimated the jailed side-branch ostial stenosis after single stent crossover due to eccentric morphology from orthogonal projection in coronary angiography. Significant changes in the MLA of jailed side-branch ostium by 3D-OCT were not observed during the follow-up.

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Eccentric morphology of jailed side-branch ostium after stent crossover in coronary bifurcation lesions: A three-dimensional optical coherence tomographic analysis

Abstract

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