Author + information
- S1936879815020865-7cc7be7f503d9b1f227543ae4ee7a175John Thompson1,
- S1936879815020865-64a74944d7598d7a3fc7a41f6a459109Alex Hill2,
- S1936879815020865-019ea140b556fc28091fb2a69c854d01Rajiv Gupta3,
- S1936879815020865-46ae60dc3c50c90e926f5b4273d98f87Srinivasan Varahoor4,
- S1936879815020865-a7090eee987de7212ff8fbdb4762c0b0William Pritchard1 and
- S1936879815020865-f15aefda8877b78f571c8195e31767e0John Karanian1
Coronary bifurcation stenting is associated with an increased risk of adverse coronary events compared to other regions stented. The purpose of this study was to quantify the motion of the left coronary artery bifurcations over the cardiac cycle and determine differences in vascular geometry, motion and compliance between swine and humans.
Gated-CT angiograms of left coronary arteries of swine and adult males were segmented across the cardiac cycle (end systole vs. end diastole) (Mimics, Materialise, Leuven, Belgium). The cross sectional area, angle, tortuosity and ellipticity were measured at three bifurcations: B1=LCX/LAD; B2=LAD/D1; and B3=LCX/M1 (Figure 1A). Pulse pressures used to calculate vascular compliance were based on literature reports of average pressures.
A significant change in human and swine cross sectional area was noted in all bifurcations over the cardiac cycle. A compliance difference was observed at B2 in humans with the D1 having 50% lower compliance compared to the proximal LAD. Figure 1 presents the bifurcation angles in each species over the cardiac cycle. The bifurcation angles significantly increased from end systole to end diastole at B1 and B3 in humans (14.3%; 9.6%) and swine (11.3%; 28.9%). The bifurcation angle at B2 was significantly greater in swine compared to humans in end systole and end diastole (32.8%; 39.5%).
A significant change in bifurcation angle and cross sectional area was observed over the cardiac cycle, however few compliance differences were noted across each bifurcation. These data illustrate that the coronary artery bifurcations are a dynamic environment in both humans and swine, which presents a challenge in pre-clinical modeling and stent design.