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Bifurcation lesions in the coronary arteries: early experience with a novel 3-dimensional imaging and quantitative analysis before and after stenting.

AIMS
The treatment of coronary bifurcation lesions is technically challenging. Conventional 2-dimensional angiography lacks the ability to properly image the true bifurcation geometry or its plaque distribution. The objectives of this study were to reconstruct coronary bifurcation lesions in 3 dimensions (3D) and to analyse the geometric changes that may occur immediately after stenting.


METHODS AND RESULTS
The CardiOp-B system (Paieon Inc.), a novel system for 3D reconstruction of the coronary vessels, was applied in a retrospective evaluation of 121 angiographic images from 27 patients (74% men, age 71+/-13 years) with bifurcation lesions in the coronary arteries treated by angioplasty procedures. Angulations between the bifurcation branches were measured before and after stenting. Side-branch involvement was found in 70% of cases. Comparison of the pre- and post-stenting angulation yielded a significantly lower angulation between the distal main branch and side branch after stenting (71+/-17 degrees versus 58+/-18 degrees , p<0.001).


CONCLUSIONS
3D reconstructions may provide new insight into complex bifurcation lesions in space and may serve as an important tool for planning interventional procedures and evaluating their results. The implications of the demonstrated angulation changes after stenting should be further evaluated.