In vivo assessment of bifurcation optimal viewing angles and bifurcation angles by three-dimensional (3D) quantitative coronary angiography

摘要: Evaluation and stenting of coronary bifurcation lesions may benefit from optimal angiographic views. The anatomy-defined viewing angle (ABOVA) is characterized by having an orthogonal view the bifurcation, such that overlap foreshortening at ostium are minimized. However, due to mechanical constraints X-ray systems, certain deep angles cannot be reached C-arm. Therefore, second best or, so-called obtainable (OBOVA) has used as alternative. This study assessed distributions ABOVA OBOVA using 3D quantitative angiography in a typical patient population. In addition, four main bifurcations were compared. Patients with obstructive disease included this multicenter registry. A novel validated QCA software package was applied reconstruct calculate 3D. list candidates including also automatically proposed software. next step, operator selected OBOVA, while applying prediction approach assure no between target other major arteries. total 194 181 patients assessed. could not 56.7% cases; being 40 (81.6%), (78.4%), 9 (17.6%), 21 (48.8%) cases for LM/LAD/LCx, LAD/Diagonal, LCx/OM, PDA/PLA, respectively. Both distributed sparsely large ranges variance: 5 ± 33 RAO, 47 ± 35 Caudal versus 4 ± 39 LAO, 35 ± 16 Caudal; 4 ± 38 50 ± 14 Cranial 14 ± 28 33 ± 5 Cranial; 21 ± 32 27 ± 17 18 ± 31 25 ± 13 34 ± 21 36 ± 21 28 ± 25 29 ± 15 Cranial. LM/LAD/LCx had smallest proximal (128° ± 24°) largest distal (80° ± 21°), compared LAD/Diagonal (151° ± 13o 48° ± 16o), LCx/OM (146° ± 18o 57° ± 16°), PDA/PLA (145° ± 19° 59° ± 17°). conclusion, variabilities existed all bifurcations. vivo roughly half current systems. Obtainable should provided alternative or best. left demonstrated variabilities.