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A coronary computed tomography angiography study on anatomical characteristics of the diagonal branch of anterior interventricular artery
- Hebei Medical University, Shijiazhuang, China
- Department of Diagnostic CT, Cangzhou Central Hospital, Cangzhou, China
open access
Abstract
Background: This study investigated the anatomical characteristics of the ramus
intermedius (RI) and its correlation with the proximal diameter of the branch
vessels of the left coronary artery (LCA) using coronary computed tomography
angiography (CCTA).
Materials and methods: We screened patients who underwent CCTA from January
to September 2021 and randomly enrolled 267 with RI (RI group) and 134
without RI (control group). We evaluated the anatomical features of RI (distribution,
proximal diameter, length). We measured the proximal diameter of the anterior
interventricular branch of the left coronary artery (LAD) and the circumflex branch
of the left coronary artery (LCX). We compared the differences between groups
in the proximal diameter of LAD and LCX and the correlation between gender
and each parameter of the LCA (LAD, LCX, RI) within the RI group. In addition,
we compared the correlation between the distribution characteristics of RI and
the proximal diameter of LAD and LCX within the RI group.
Results: The LAD and LCX proximal diameters in the RI group were significantly
smaller than those in the control group (p < 0.05). Comparisons within the RI
group showed the following results: the RI distribution, RI diameter and length,
and the LCX proximal diameter were not significantly different between male
and female patients (p > 0.05), and the LAD proximal diameter was significantly
larger in male than in female patients (p < 0.05). There were statistically significant
differences in the LAD and LCX proximal diameters between the different
RI distribution groups (p < 0.05). Based on the pairwise comparison, there were
significant differences in the LAD (LCX) proximal diameter between the RI-beside-
-the-LAD (LCX) group and the RI-middle group, as well as between the RI-beside-
-the-LAD (LCX) group and the RI-beside-the-LCX (LAD) group (p < 0.05).
Conclusions: A CCTA accurately evaluated the anatomical characteristics of an
RI, which has an impact on the proximal diameter of the branch vessels of the
LCA (i.e. LAD and LCX), the degree of influence of which is correlated with the
RI distribution.
Abstract
Background: This study investigated the anatomical characteristics of the ramus
intermedius (RI) and its correlation with the proximal diameter of the branch
vessels of the left coronary artery (LCA) using coronary computed tomography
angiography (CCTA).
Materials and methods: We screened patients who underwent CCTA from January
to September 2021 and randomly enrolled 267 with RI (RI group) and 134
without RI (control group). We evaluated the anatomical features of RI (distribution,
proximal diameter, length). We measured the proximal diameter of the anterior
interventricular branch of the left coronary artery (LAD) and the circumflex branch
of the left coronary artery (LCX). We compared the differences between groups
in the proximal diameter of LAD and LCX and the correlation between gender
and each parameter of the LCA (LAD, LCX, RI) within the RI group. In addition,
we compared the correlation between the distribution characteristics of RI and
the proximal diameter of LAD and LCX within the RI group.
Results: The LAD and LCX proximal diameters in the RI group were significantly
smaller than those in the control group (p < 0.05). Comparisons within the RI
group showed the following results: the RI distribution, RI diameter and length,
and the LCX proximal diameter were not significantly different between male
and female patients (p > 0.05), and the LAD proximal diameter was significantly
larger in male than in female patients (p < 0.05). There were statistically significant
differences in the LAD and LCX proximal diameters between the different
RI distribution groups (p < 0.05). Based on the pairwise comparison, there were
significant differences in the LAD (LCX) proximal diameter between the RI-beside-
-the-LAD (LCX) group and the RI-middle group, as well as between the RI-beside-
-the-LAD (LCX) group and the RI-beside-the-LCX (LAD) group (p < 0.05).
Conclusions: A CCTA accurately evaluated the anatomical characteristics of an
RI, which has an impact on the proximal diameter of the branch vessels of the
LCA (i.e. LAD and LCX), the degree of influence of which is correlated with the
RI distribution.
Keywords
ramus intermedius, bifurcation angle, coronary computed tomography angiography
Title
A coronary computed tomography angiography study on anatomical characteristics of the diagonal branch of anterior interventricular artery
Journal
Issue
Article type
Original article
Pages
822-829
Published online
2022-11-29
Page views
669
Article views/downloads
434
DOI
Pubmed
Bibliographic record
Folia Morphol 2023;82(4):822-829.
Keywords
ramus intermedius
bifurcation angle
coronary computed tomography angiography
Authors
D.-Q. Zhang
Y.-F. Xu
Y.-P. Dong
S.-J. Yu
- Ajayi NO, Lazarus L, Vanker EA, et al. The prevalence and clinical importance of an "additional" terminal branch of the left coronary artery. Folia Morphol. 2013; 72(2): 128–131.
- Cui Y, Zeng W, Yu J, et al. Quantification of left coronary bifurcation angles and plaques by coronary computed tomography angiography for prediction of significant coronary stenosis: A preliminary study with dual-source CT. PLoS One. 2017; 12(3): e0174352.
- Galbraith EM, McDaniel MC, Jeroudi AM, et al. Comparison of location of "culprit lesions" in left anterior descending coronary artery among patients with anterior wall ST-segment elevation myocardial infarction having ramus intermedius coronary arteries versus patients not having such arteries. Am J Cardiol. 2010; 106(2): 162–166.
- Genuardi L, Chatzizisis YS, Chiastra C, et al. Local fluid dynamics in patients with bifurcated coronary lesions undergoing percutaneous coronary interventions. Cardiol J. 2021; 28(2): 321–329.
- Gong T. Regression equations of z-scores of aorta and coronary arteries in healthy minors in Chongqing, China. Journal of Chongqing Medical University. 2020.
- Gwon HC. Understanding the coronary bifurcation stenting. Korean Circ J. 2018; 48(6): 481–491.
- Hahn JY, Chun WJ, Kim JH, et al. Predictors and outcomes of side branch occlusion after main vessel stenting in coronary bifurcation lesions: results from the COBIS II Registry (COronary BIfurcation Stenting). J Am Coll Cardiol. 2013; 62(18): 1654–1659.
- Huo Y, Finet G, Lefevre T, et al. Which diameter and angle rule provides optimal flow patterns in a coronary bifurcation? J Biomech. 2012; 45(7): 1273–1279.
- Kim HY, Doh JH, Lim HS, et al. Identification of coronary artery side branch supplying myocardial mass that may benefit from revascularization. JACC Cardiovasc Interv. 2017; 10(6): 571–581.
- Kralev S, Poerner TC, Basorth D, et al. Side branch occlusion after coronary stent implantation in patients presenting with ST-elevation myocardial infarction: clinical impact and angiographic predictors. Am Heart J. 2006; 151(1): 153–157.
- Liu XB. Atherosclerosis in the lumen of a bifurcated left coronary artery and the proximal segment. Journal of Xinjiang Medical University. 2019.
- Redfors B, Généreux P, Witzenbichler B, et al. Percutaneous coronary intervention for bifurcation lesions. Interv Cardiol Clin. 2016; 5(2): 153–175.
- Ren XJ. Quantification of left coronary artery branch angle and coronary artery diameter lines by 256iCT. Journal of Hebei Medical University. 2014.
- Sun Z, Chaichana T. An investigation of correlation between left coronary bifurcation angle and hemodynamic changes in coronary stenosis by coronary computed tomography angiography-derived computational fluid dynamics. Quant Imaging Med Surg. 2017; 7(5): 537–548.
- Verim S, Öztürk E, Küçük U, et al. Cross-sectional area measurement of the coronary arteries using CT angiography at the level of the bifurcation: is there a relationship? Diagn Interv Radiol. 2015; 21(6): 454–458.
- Zhang D, Dou K. Coronary bifurcation intervention: what role do bifurcation angles play? J Interv Cardiol. 2015; 28(3): 236–248.