| 1 | Comparison of two and three dimensional quantitative coronaryangiography to intravascular ultrasound in the assessment of leftmain coronary artery bifurcation lesions显示文摘Background Angiographic evaluation of left main coronary artery (LMCA) bifurcation lesions is often limited, twodimensional (2D) quantitative coronary angiography (QCA) with segmental analysis provides accuracy for quantificationof the degree of stenosis in the main vessel and side branch ostium but can be affected by foreshortening and variablemagnification. The accuracy of three dimensional (3D) QCA has recently developed to overcome 2D QCA limitations,however, accuracy and precision of 3D bifurcation QCA measurements in LMCA bifurcation lesions has not beenestablished.Methods We investigated whether such 3D and 2D bifurcation QCA measurements differ in their accuracy in assessingsignificant LMCA bifurcation lesions defined by intravascular ultrasound (IVUS) as a minimum luminal area (MLA) 〈6 mm2of LMCA and MLA 〈4 mm2 of proximal left anterior descending (LAD) and/or proximal left circumflex (LCX)Results LMCA bifurcation lesions were assessed in 44 patients undergoing elective percutaneous coronary intervention.From 2D QCA measurements, MLA correlated moderately with threshold intravascular ultrasound MLA for LMCA (r=0.81,P 〈0.000 1), LAD 0=0.54, P=0.000 1) and LCX (r=0.58, P 〈0.000 1). Severity of lesion as MLA by derived 3D QCA,correlated moderately with threshold intravascular ultrasound MLA for LMCA (t=0.84, P 〈0.000 1), LAD (t=0.53, P=0.000 2);LCX (r=0.66, P 〈0.000 1). Overall, the C statistics tended to be slightly higher for 3D QCA and 2D QCA measurementsin LMCA segment compared with proximal LAD and LCX segments, and there were no significant predictive power ofpercent diameter stenosis and percent area stenosis on 3D QCA for LCX IVUS MLA 〈4 mm2 (percent diameter stenosis:area under curve 0.55, cutoff 23%, sensitivity 88%, specificity 37%, P=0.618 6; percent arer stenosis: area under curve0.56, cutoff 41%, sensitivity 83%, specificity 38%, P=0.518 4, respectively).Conclusions The accuracy of 3D bifurcation QCA in detecting significant LMCA bifurcation lesions is limited, especiallythe proximal LCX ostium. When IVUS is not available or contraindicated, 3D QCA may assist in the evaluation ofintermediate LMCA lesions with MLA. | | 2014 | Chinese Medical Journal2014，，6： | 3 |
| 2 | 双支架术式的体外模拟研究显示文摘目的研究不同双支架术式(包括经典挤压支架术、双对吻挤压支架术和裙裤支架术)在不同分叉角度的分叉血管模型中的表现。方法基于不同分叉角度的硅树脂分叉血管模型,全程使用微聚焦相机照相,观察运用不同双支架术后的支架形态学以及分支开口间隙区的差异。结果基于'T'型分叉(远端分叉角度90°):运用经典挤压支架术,再次放置导丝从远端网眼进入分支,完成对吻扩张后,分支开口嵴侧无支架钢梁覆盖;无论是经典挤压支架术(再次放置导丝从近端网眼进入分支),还是双对吻挤压支架术(两次放置导丝都从近端网眼进入),分支开口嵴侧都留有间隙区,但双对吻挤压支架术后的间隙空间小于经典挤压支架术。基于'Y'型分叉(远端分叉角度<70°):双对吻挤压支架术和裙裤支架术后分支开口无间隙形成;裙裤支架术若两次放置导丝都从近端网眼进入分支,术后分支开口会形成新的金属嵴。结论远端分叉角度是决定双支架术后分支开口间隙形成的重要解剖学因素。对于'T'型分叉,运用挤压支架术在分支开口嵴侧都留有间隙,但双对吻挤压支架术后的间隙空间明显小于经典挤压支架术;双对吻挤压支架术两次放置导丝都应从近端网眼进入分支;裙裤支架术两次放置导丝都应从远端网眼进入分支。 | 高晓飞 张俊杰 葛震 肖平喜 叶飞 陈绍良 | 2015 | 中国介入心脏病学杂志2015，23，11： | 0 |
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