IN VIVO QUANTIFICATION OF HUMAN CORONARY ARTERY DEFORMATION FROM CARDIAC-GATED COMPUTED TOMOGRAPHY DATA

摘要

Despite significant advances in percutaneous coronary interventions (PCI), bifurcation lesions still remain technically challenging for treatment. In an attempt to treat bifurcation lesions, innovative interventional techniques such as T-stenting, V-stenting and crush stenting have been developed. However, stenting both main and branch vessels inherently involves geometrical constraint on the devices at the site of a branch junction. Moreover, dynamic cardiac motion may cause significant deformation of the coronary artery (Fig. 1) and hence may adversely impact the functionality as well as durability of stents. This critical issue has been emphasized by recent studies on stent strut fracture-induced restenosis in a bifurcation lesion [1]. Although it has been hypothesized that cardiac motion causes significant mechanical stress on coronary stents, three-dimensional (3D) characteristics of the coronary artery deformation are not well understood. The purpose of this study was to quantify the change in the bifurcation angle between the left anterior descending coronary artery (LAD) and left circumflex artery (LCX), and the curvature change of the LAD during the cardiac cycle.