Abstract:
OBJECTIVE:Vessel bifurcations are prone to atherosclerotic plaque accumulation. Using volumetric intravascular ultrasound analysis, we investigated atheroma distribution at human coronary bifurcations in vivo. METHODS:We analyzed plaque distribution in 49 left anterior descending coronary artery-diagonal and 20 left circumflex coronary artery-obtuse marginal bifurcations with <50% angiographic stenosis. Cross-sections were analyzed at 1 mm intervals in segments 5 mm proximal and distal from the bifurcation. Planimetry of the lumen and external elastic membrane (EEM) was performed and plaque thickness measured at four different points relative to the branch: 0 degrees, 90 degrees, 180 degrees and 270 degrees. EEM, lumen and plaque volume and percentage plaque burden (plaque volume/EEM volume) were calculated in the proximal and distal segments. The side-branch take-off angle was analyzed in the cross-sectional images. RESULTS:Volumetric analysis showed that EEM, lumen and plaque were larger (P<0.001) in proximal segments than distal segments, whereas percent plaque burden was similar in these segments. Plaque accumulated on the opposite wall to the flow divider. Plaque distribution tended to be more eccentric in distal segments (P=0.05) compared to proximal segments. In 26 of 69 lesions, an asymmetric side-branch take-off was found and was associated with asymmetric plaque distribution compared to those lesions that had a symmetric side-branch take-off (P<0.01). CONCLUSION:We found characteristic patterns of plaque distribution at coronary bifurcations. Proximal segments demonstrated larger plaque volume than distal segments, despite similar percentages of plaque burden. Plaque volume accumulated opposite to the flow divider, especially in distal segments. The side-branch take-off angle in the cross-sectional plane influenced the plaque distribution in bifurcation lesions.
journal_name
Coron Artery Disjournal_title
Coronary artery diseaseauthors
Badak O,Schoenhagen P,Tsunoda T,Magyar WA,Coughlin J,Kapadia S,Nissen SE,Tuzcu EMdoi
10.1097/01.mca.0000076511.29238.f1subject
Has Abstractpub_date
2003-06-01 00:00:00pages
309-16issue
4eissn
0954-6928issn
1473-5830journal_volume
14pub_type
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journal_title:Coronary artery disease
pub_type: 杂志文章,meta分析
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更新日期:2016-09-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章
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journal_title:Coronary artery disease
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pub_type: 杂志文章
doi:10.1097/00019501-199711000-00006
更新日期:1997-11-01 00:00:00
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
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pub_type: 杂志文章
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更新日期:1996-02-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Coronary artery disease
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journal_title:Coronary artery disease
pub_type: 杂志文章
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更新日期:1993-10-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章
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更新日期:2014-08-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章,meta分析,评审
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更新日期:2008-08-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 社论
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更新日期:2015-06-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章
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更新日期:1995-07-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章
doi:10.1097/00019501-199304000-00009
更新日期:1993-04-01 00:00:00
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journal_title:Coronary artery disease
pub_type: 杂志文章
doi:
更新日期:2004-06-01 00:00:00