Coronary artery bifurcations are a common challenging lesion subset accounting for approximately 10% to 20% of all percutaneous coronary interventions. The provisional T-stenting approach is generally recommended as the first-line management of most lesions. Carina shift is suggested to be the predominant mechanism of side-branch pinching during provisional T-stenting and has been indirectly inferred from bench work and other intravascular imaging modalities. Offline 3-dimensional (3D) reconstructions of patients studied in the first-in-man trial of the high-frequency (160 frames/s) Terumo optical frequency domain imaging system were undertaken using volume-rendering software. Through a series of 3D reconstructions, several novel hypothesis-generating concepts are presented.

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JACC: Cardiovascular Interventions
Erasmus MC: University Medical Center Rotterdam

Farooq, V., Serruys, P., Heo, J., Gogas, B., Okamura, T., Gomez-Lara, J., … van Geuns, R. J. (2011). New insights into the coronary artery bifurcation: Hypothesis-generating concepts utilizing 3-dimensional optical frequency domain imaging. JACC: Cardiovascular Interventions, 4(8), 921–931. doi:10.1016/j.jcin.2011.06.004