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Side branch occlusion has been implicated as a complication after percutaneous coronary bifurcation intervention. The role of carina bifurcation angle as one of the characteristics of the coronary bifurcation lesion in causing side branch occlusion after percutaneous coronary bifurcation lesion intervention is still debated.
This is a cross-sectional study to assess the relationship between carina bifurcation angle and side branch occlusion in elective percutaneous coronary bifurcation lesions intervention. CAAS 5.1 software was used to measure bifurcation carina angle. Evaluation of acute occlusion of a side branch conducted after an elective percutaneous coronary intervention.
A total of 113 lesions in 108 patients that met the inclusion criteria from February 2016 to October 2016. Side branch occlusion occurred in 15 lesions (13.3%), with median carina bifurcation angle 19,170 (p<0.001). Ipsilateral plaque distribution was found in 9 lesions (22%, p=0.027), stenosis in proximal segment was found in 13 lesions (19.4%, p=0.20), and side branch stenosis was found in 12 lesions (28.6%, p<0.001). Multivariate analysis showed there is a relationship between carina bifurcation angle with side branch occlusion, OR 0,863 (95% CI 0.803-0.927). From ROC curve we found a cut-off value ≤33.710, AUC 0,90 (95% CI 0.83-0.97) with sensitivity 93% and specificity 73%.
There is an association between carina bifurcation angle and side branch occlusion. Increased risk of side branch occlusion was found in a taper angle.