A novel 3-D reconstruction system for the assessment of bifurcation lesions treated by the mini-crush technique

Background: Conventional two-dimensional angiography lacks the ability to properly image the true bifurcation geometry, and its percutaneous coronary intervention-induced changes in the clinical setting. Methods and Results: A novel three-dimensional reconstruction system was investigated by retrospectively analyzing 39 lesions in 35 consecutive patients with coronary bifurcation disease treated with the mini-crush technique. At baseline, significant correlations were proved between two- and three-dimensional systems in terms of either reference vessel diameter (R 2 = 0.68 and 0.29 for main and side branches, respectively), minimum lumen diameter (R 2 = 0.73 and 0.36), stenosis diameter (R 2 = 0.69 and 0.29), and lesion length (R 2 = 0.48 and 0.58). These results were consistent with those observed after the procedure and at 8-month follow-up. Lesion length was significantly longer with the three-dimensional compared to the two-dimensional system for both main and side branches (P < 0.001, and P = 0.007, respectively). Conclusions: The three-dimensional quantitative reconstruction system may provide accurate evaluation of the complex curvilinear structure of bifurcation lesions when using a double stent technique. © 2009, Wiley Periodicals, Inc.