| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 2963067 | Journal of Cardiology | 2015 | 6 Pages |
BackgroundAngiographic 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).MethodsUsing 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.ResultsThe MLA of jailed side-branch ostium calculated from quantitative coronary angiography (QCA) assuming a circular lumen markedly decreased after stent implantation (1.73 ± 1.22 mm2 pre-intervention to 0.84 ± 0.91 mm2 post-intervention, p < 0.001). However, the MLA of jailed side-branch ostium measured at post-intervention by 3D-OCT (2.67 ± 1.75 mm2) 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 ± 1.50 mm2 at 3–6 months post-intervention; 2.44 ± 1.27 mm2 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).ConclusionsCompared 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.
