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November 6, 2023Frontiers in Cardiovascular MedicineOpen Access

Multislice computerized tomography coronary angiography can be a comparable tool to intravascular ultrasound in evaluating “true” coronary artery bifurcations

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Why the study?

Coronary bifurcation atherosclerosis depends on angles, flow, and extensive branching, prompting investigation into the ability of CTCA to determine plaque characteristics of true bifurcations compared with IVUS and its influence on side branch fate after PCI.

Does CTCA provide comparable information to IVUS for evaluating plaque characteristics in true coronary bifurcations and predicting side branch compromise?

Population

70 patients with 72 true bifurcations

Comparison

CTCA vs IVUS

Design

Observational study

Key result

Circumferential plaque in the proximal main branch segment detected by CT coronary angiography was an independent predictor of side branch compromise after provisional stenting (OR 3.962).

Authors

ARAnja RadunovićRVRadosav VidakovićSTStefan Timčić

Discussion

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Member takes

Overview

May aid side branch risk stratification in bifurcation PCI; leaves open prospective validation vs IVUS.

Study Design

Type

Observational (n=70)

Multicenter

No

Structured PICO

Does CTCA provide comparable information to IVUS for evaluating plaque characteristics in true coronary bifurcations and predicting side branch compromise?

P
Population
70 patients with 72 'true' coronary artery bifurcations (69.4% in the left anterior descending-diagonal territory)
I
Intervention
Multislice computerized tomography coronary angiography (CTCA)
C
Comparator
Intravascular ultrasound (IVUS)
O
Outcome
Atherosclerotic plaque characteristics and side branch compromise after percutaneous coronary interventionsurrogate

Main Result

Effect estimate: OR 3.962 (95% CI 1.170-13.418)

p-value: p=0.027

CTCA provides comparable information to IVUS for evaluating true coronary bifurcations and can predict side branch compromise after provisional stenting.

Limitations

  • Semiautomated anatomical co-registration between CTCA and IVUS can lead to bias in measurements.
  • Unable to perform volumetric plaque analysis to evaluate the possible effect of plaque shift on the side branch fate.
  • Unable to perform plaque thickness quantitative analysis when evaluating circumference cross-section.

Cite This Study

Radunović et al. (2023) conducted an observational in "true" native coronary artery bifurcations (n=70). CT coronary angiography (CTCA) vs. Intravascular ultrasound (IVUS) was evaluated on Side branch compromise (TIMI < 3) (OR 3.962, 95% CI 1.170-13.418, p=0.027). Circumferential plaque in the proximal main branch segment detected by CT coronary angiography was an independent predictor of side branch compromise after provisional stenting (OR 3.962).

synapsesocial.com/papers/6a0f7c5b2badbc352afe3d64https://doi.org/10.3389/fcvm.2023.1292517
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