Optimal diameter of diseased bifurcation segment: A practical rule for percutaneous coronary intervention

Yunlong Huo, Gérard Finet, Thierry Lefèvre, Yves Louvard, Issam Moussa, Ghassan S. Kassab

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: The percutaneous repair of a diseased segment should consider the dimensions of other segments of a bifurcation in order to ensure the optimality of flow through the bifurcation. The question is, if the diameters of two segments of a bifurcation are known, can an optimal diameter of the third diseased segment be determined such that the bifurcation has an optimal geometry for flow transport? Various models (i.e., Murray, Finet, area-preservation and HK models) that express a diameter relationship of the three segments of a bifurcation have been proposed to answer the question. Methods and results: In this study the four models were compared with experimental measurements on epicardial coronary bifurcations of patients and swine. The HK model is found to be in agreement with morphometric measurements of all bifurcation types and is based on the minimum energy hypothesis while Murray and area-preservation models are in agreement with experimental measurements for bifurcations with daughter diameter ratio (i.e., small daughter diameter/large daughter diameter) ≤0.25 and Finet model is in agreement for bifurcations with daughter diameter ratio ≥0.75. Conclusions: The HK model provides a comprehensive rule for the percutaneous reconstruction of the diameters of diseased vessels and has a physical basis.

Original languageEnglish (US)
Pages (from-to)1310-1316
Number of pages7
JournalEuroIntervention
Volume7
Issue number11
DOIs
StatePublished - Mar 2012
Externally publishedYes

Keywords

  • Bifurcation diameter relationship
  • Diameter ratio
  • PCI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this