Planning of Intervention Therapy for Bifurcation Stenting Based on CT - Coronary Angiography

Oleg Volikov, Gennadiy Khubulava, Andrey Shishkevich, Igor Oleksyuk, Kirill Kozlov, Igor Zheleznyak, Igor Minkov, Sergey Mikhailov, Ekaterina Bobrovskaya, Zaur Abdullaev

Military-Medical academy, Sankt-Petersburg, Russia

Date, time and location: 2018.05.26 15:30, Congress Hall, 2F–A

Abstract

Objective: evaluation of efficiency of theCT -coronary angiography for planning the tactics of bifurcation stenting and the selection of optimal stents.

Materials and methods: We analyzed the experience of 6 cases of coronary angiography and stenting of bifurcation lesions of the coronary arteries, followed by a retrospective analysis of previously obtained CT coronarography data in patients with coronary heart disease.

All coronary angiography made to the patients showed bifurcation lesions: in one person lesion of theLCX at the level of OM retreat, in 3 persons lesion of LAD at level of deviation diagonal artery1, in 2 persons lesion of distal segment of RCA at the level of right posterolateral artery and PDA divergence.  Analysis of the affected area was carried out using a standard software package. The following parameters were taken for the design parameters: the extension, structure and prevalence of atherosclerotic plaque in relation to bifurcation. Based on the obtained data, a stent of optimal size was selected. After coronary angiography and stenting, the data of previously performed CT coronary angiography were retrospectively evaluated. Analysis of CT images was also performed on three parameters: the extension, structure and prevalence of atherosclerotic plaque and its involvement in the bifurcation lesion.

Results:In a retrospective comparison of coronary angiography and CT coronary angiography, a more accurate visualization of atherosclerotic plaque was noted in CT coronary angiography.

Conclusion:CT-coronarography data for bifurcation lesions allow to fully prepare for bifurcation stenting. Carrying out of complex computer tomography diagnostics in patients with bifurcation lesions allows to reveal the structure and prevalence of atherosclerotic plaque in the conditions of bifurcation lesion, to suggest a set of instruments for performing cortical coronary intervention, which in turn helps to reduce the operating time in X-ray operating room and to predict the assortment of coronary bifurcation stents.