Ex vivo analysis of human coronary bifurcation anatomy: defining the main vessel-to-side-branch transition zone
| Autor: | Mary E. Russell, Gary Binyamin, Eitan Konstantino |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
Swine Magnification Coronary Angiography Corrosion Casting Curvature Main vessel Intersection Cadaver Image Processing Computer-Assisted Animals Humans Medicine Coronary bifurcation Aged Aged 80 and over Microscopy business.industry Anatomy Middle Aged Coronary Vessels Coronary arteries Ostium medicine.anatomical_structure cardiovascular system Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | EuroIntervention. 5:96-103 |
| ISSN: | 1774-024X |
| Popis: | Aims: Defining vessel diameters and angles that comprise coronary side-branch intersections could assist in tailoring treatments to match anatomy, improve haemodynamic flow, and minimise mechanical trauma. We sought to characterise intersections of main vessels and side-branches by measuring actual diameters, angles, and shapes at the ostia in human coronary arteries. Methods and results: Polymer casts were created using coronary trees from 23 adult cadaver hearts. Seventy-five arterial intersections between main vessels and side-branches were captured using the combination of a microscope (Smartscope MVP100) and computer program (Gage-X metrology software) specifically calibrated for video-based inspection and measurement (34-fold magnification). The intersection between main vessels and side-branches was a multifaceted, curvilinear transition rather than a bisecting angle. The shape of the ostia was typically elliptical rather than circular. Mean diameters were 2.88 mm in proximal main vessels, 2.34 mm in ostia, and 2.00 mm in side-branches (first-level branches). Obtuse proximal (150 degrees) and distal (111 degrees) angles with accentuated side-branch taper create a "barn door" effect with wider curvature at the bottom. Conclusions: Matching treatments to these various forms of asymmetry at the main vessel-to-side-branch intersection may minimise injury and optimise scaffolding, and haemodynamic flow. |
| Databáze: | OpenAIRE |
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