Assessment of fractal ratio of vessel diameters in coronary bifurcation lesions by angiography and intravascular ultrasound.

IF 3.1 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Intervention and Therapeutics Pub Date : 2024-10-29 DOI:10.1007/s12928-024-01057-7
Yoshinobu Murasato, Yoshihisa Kinoshita, Masahiro Yamawaki, Takayuki Okamura, Ryoji Nagoshi, Tatsuhiro Fujimura, Yoshihiro Takeda, Kenichi Fujii, Shin-Ichiro Yamada, Toshiro Shinke, Junya Shite
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Abstract

Physiological coronary branching at the bifurcation has a constant fractal ratio (FR) of the diameter of the mother vessel to the sum of daughter vessels on quantitative coronary angiography (QCA). We sought to investigate the FR of diseased coronary bifurcations using QCA and intravascular ultrasound (IVUS) and its impact on late lumen loss after percutaneous coronary intervention (PCI). In multicentre prospective studies of the J-REVERSE and 3D OCT Bifurcation Registry, 402 and 109 bifurcations treated with stenting that completed QCAs and IVUS examinations, respectively were analysed. FR was investigated at the reference sites pre-PCI and the minimum lumen diameter (MLD) post-PCI. In the QCA analysis, constant FR was observed in the pre-PCI reference (0.62 ± 0.08) and in the post-PCI MLD site (0.74 ± 0.10), which was greater (p < 0.05). In the IVUS analysis, the constant FR in the post-PCI MLD site (0.67 ± 0.06) was similar to that in the pre-PCI reference (0.66 ± 0.06) and close to the physiological FR value (0.678). The fourth quintile of pre-PCI reference FR in the IVUS analysis showed numerically least late lumen loss in proximal main vessel (MV) (0.16 ± 0.22 mm) and distal MV (0.13 ± 0.32 mm) and significantly less in the side branch compared to higher FR quintile (- 0.14 ± 0.27 mm vs. 0.10 ± 0.19 mm, p = 0.004), while no relationship was found in the QCA analysis. FR in the diseased coronary bifurcation was more accurately assessed on IVUS than on QCA, and the accomplishment of physiological FR might lead to less late lumen loss after bifurcation PCI.

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通过血管造影和血管内超声评估冠状动脉分叉病变血管直径的分形比。
定量冠状动脉血管造影(QCA)显示,分叉处的生理性冠状动脉分支具有恒定的分形比(FR),即母血管直径与子血管直径之和。我们试图利用 QCA 和血管内超声(IVUS)研究病变冠状动脉分叉处的分形比及其对经皮冠状动脉介入治疗(PCI)后晚期管腔损失的影响。在 J-REVERSE 和 3D OCT 分叉注册的多中心前瞻性研究中,分别对完成 QCA 和 IVUS 检查的 402 个和 109 个接受支架治疗的分叉进行了分析。对PCI前的参考部位和PCI后的最小管腔直径(MLD)进行了FR调查。在 QCA 分析中,PCI 前的参考点(0.62 ± 0.08)和 PCI 后的 MLD 点(0.74 ± 0.10)均观察到恒定的 FR,且 FR 更大(p<0.05)。
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来源期刊
Cardiovascular Intervention and Therapeutics
Cardiovascular Intervention and Therapeutics CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
6.30
自引率
12.50%
发文量
68
期刊介绍: Cardiovascular Intervention and Therapeutics (CVIT) is an international journal covering the field of cardiovascular disease and includes cardiac (coronary and noncoronary) and peripheral interventions and therapeutics. Articles are subject to peer review and complete editorial evaluation prior to any decision regarding acceptability. CVIT is an official journal of The Japanese Association of Cardiovascular Intervention and Therapeutics.
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