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Morphometric Analysis of the Left Main Coronary Truncus, Left Anterior Descending Artery, Circumflex Artery, and Intermediate Artery: Measurements of Length, Angle, and Diameter

Year 2023, Volume: 5 Issue: Supplement (1) - Innovations in Medicine and Healthcare in the 100th Year of the Republic, 11 - 5, 19.10.2023
https://doi.org/10.37990/medr.1326903

Abstract

Aim: The aim of our study was to group the left main coronary truncus (LMCT) according to its branching structure and to determine its length, angle and diameter measurements together with LMCT’s main branches which are left anterior descending artery (LAD), circumflex artery (Cx) and intermediate artery (IA).
Material and Methods: Between June 2019 and June 2021, coronary angiographies of 150 (female-39%, male-61%) patients were analysed by digital subtraction angiography. For each patient, the measurements of the length and diameter of the LMCT, LAD (proximal-middle-distal parts), Cx (proximal-middle-distal parts), and IA were calculated. Measurements were performed with 2-dimensional measurement technique.
Results: The LMCT showed bifurcation pattern in 90.7% and trifurcation pattern in 9.3% of cases. The mean LMCA length and diameter were 15.9±5.7 mm and 6.0±0.9 mm, respectively. The LAD-CX angle defined as the bifurcation angle was 75.8±25.5°. The results that differed significantly between the sexes were the LMCT-LAD angle (159.2±17.8°) and the LAD-distal diameter (2.5±0.5 mm) (p<0.05).
Conclusion: In our study, the length-angle-diameter measurements of the LMCT and its main branches (LAD, Cx, IA) were determined in detail. These results are important anatomical data that may contribute to the diagnosis and treatment procedures, especially in cardiology, cardiovascular surgery, and radiology.

References

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  • Ngam PI, Ong CC, Chai P, et al. Computed tomography coronary angiography - past, present and future. Singapore Med J. 2020;61:109-15.
  • Yamamoto M, Okura Y, Ishihara M, et al. Development of digital subtraction angiography for coronary artery. J Digit Imaging. 2009;22:319-25.
  • WHO, World Health Statistics, https://www.who.int/data/gho/publications/world-health-statistics access date 01.11.2023
  • Givehchi S, Safari MJ, Tan SK, et al. Measurement of coronary bifurcation angle with coronary CT angiography: a phantom study. Phys Med. 2018;45:198-204.
  • Chaichana T, Sun Z, Jewkes J. Computation of hemodynamics in the left coronary artery with variable angulations. J Biomech. 2011;44:1869-78.
  • Ellwein L, Marks DS, Migrino RQ, et al. Image-based quantification of 3D morphology for bifurcations in the left coronary artery: Application to stent design. Catheter Cardiovasc Interv. 2016;87:1244-55.
  • Medrano-Gracia P, Ormiston J, Webster M, et al. A computational atlas of normal coronary artery anatomy. Euro Intervention. 2016;12:845-54.
  • Kawasaki T, Koga H, Serikawa T, et al. The bifurcation study using 64 multislice computed tomography. Catheter Cardiovasc Interv. 2009;73:653-8.
  • Gazetopoulos N, Ioannidis PJ, Marselos A, et al. Length of main left coronary artery in relation to atherosclerosis of its branches. A coronary arteriographic study. Br Heart J. 1976;38:180-5.
  • Pereira da CostaSobrinho O, Dantas de Lucena J, SilvaPessoa R, et al. Anatomical study of length and branching pattern of main trunk of the left coronary artery. Morphologie. 2019;103:17-23.
  • Raut BK, Patil VN, Cherian G. Coronary artery dimensions in normal Indians. Indian Heart J. 2017;69:512-4.
  • Zhang LR, Xu DS, Liu XC, et al. Coronary artery lumen diameter and bifurcation angle derived from CT coronary angiographic image in healthy people. Zhonghua Xin Xue Guan Bing Za Zhi. 2011;39:1117-23.
Year 2023, Volume: 5 Issue: Supplement (1) - Innovations in Medicine and Healthcare in the 100th Year of the Republic, 11 - 5, 19.10.2023
https://doi.org/10.37990/medr.1326903

Abstract

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References

  • Gray H, Standring S, Ellis H, Berkovitz BKB. Gray's anatomy: the anatomical basis of clinical practice. 39th edition. Edinburgh, New York: Elsevier Churchill Livingstone, 2005;2847-54.
  • Faletra FF, Pandian NG, Ho SY. Anatomy of the Heart by Multislice Computed Tomography. 1st edition. UK: John Wiley&Sons Ltd, West Sussex, 2008;88-107.
  • Reig J, Petit M. Main trunk of the left coronary artery: anatomic study of the parameters of clinical interest. Clin Anat. 2004;17:6-13.
  • Loukas M, Groat C, Khangura R, et al. The normal and abnormal anatomy of the coronary arteries. Clin Anat. 2009;22:114-28.
  • Singh S, Ajayi N, Lazarus L, Satyapal KS. Anatomic study of the morphology of the right and left coronary arteries. Folia Morphol (Warsz). 2017;76:668-74.
  • Standring S. Gray’s Anatomy, The Anatomical Basis of Clinical Practice. Fort-first Edition. Elsevier Churchill Livingstone, 2016;1561-5.
  • Temov K, Sun Z. Coronary computed tomography angiography in vestigation of the association between left main coronary artery bifurcation angle and risk factors of coronary artery disease. Int J Cardiovasc Imaging. 2016;32:129-37.
  • Cecchi E, Giglioli C, Valente S, et al. Role of hemodynamic shear stress in cardiovascular disease. Atherosclerosis. 2011;214:249-56.
  • Moon SH, Byun JH, Kim JW, et al. Clinical usefulness of the angle between left main coronary artery and left anterior descending coronary artery for the evaluation of obstructive coronary artery disease. PLoS One. 2018;13:e0202249.
  • Pflederer T, Ludwig J, Ropers D, et al. Measurement of coronary artery bifurcation angles by multidetector computed tomography. Invest Radiol. 2006;41:793-8.
  • Limanto DH, Chang HW, Kim DJ, et al. Coronary artery size as a predictor of Y-graft patency following coronary artery bypass surgery. Medicine (Baltimore). 2021;100:e24063.
  • Medrano-Gracia P, Ormiston J, Webster M, et al. A study of coronary bifurcation shape in a normal population. J Cardiovasc Transl Res. 2017;10:82-90.
  • Virani SS, Alonso A, Benjamin EJ, et al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 2020;141:e139-596.
  • Beier S, Ormiston J, Webster M, et al. Hemodynamics in Idealized Stented Coronary Arteries: Important Stent Design Considerations. Ann Biomed Eng. 2016;44:315-29.
  • Chilcote WA, Modic MT, Pavlicek WA, et al. Digital subtraction angiography of the carotid arteries: a comparativestudy in 100 patients. Radiology. 1981;139:287-95.
  • Ngam PI, Ong CC, Chai P, et al. Computed tomography coronary angiography - past, present and future. Singapore Med J. 2020;61:109-15.
  • Yamamoto M, Okura Y, Ishihara M, et al. Development of digital subtraction angiography for coronary artery. J Digit Imaging. 2009;22:319-25.
  • WHO, World Health Statistics, https://www.who.int/data/gho/publications/world-health-statistics access date 01.11.2023
  • Givehchi S, Safari MJ, Tan SK, et al. Measurement of coronary bifurcation angle with coronary CT angiography: a phantom study. Phys Med. 2018;45:198-204.
  • Chaichana T, Sun Z, Jewkes J. Computation of hemodynamics in the left coronary artery with variable angulations. J Biomech. 2011;44:1869-78.
  • Ellwein L, Marks DS, Migrino RQ, et al. Image-based quantification of 3D morphology for bifurcations in the left coronary artery: Application to stent design. Catheter Cardiovasc Interv. 2016;87:1244-55.
  • Medrano-Gracia P, Ormiston J, Webster M, et al. A computational atlas of normal coronary artery anatomy. Euro Intervention. 2016;12:845-54.
  • Kawasaki T, Koga H, Serikawa T, et al. The bifurcation study using 64 multislice computed tomography. Catheter Cardiovasc Interv. 2009;73:653-8.
  • Gazetopoulos N, Ioannidis PJ, Marselos A, et al. Length of main left coronary artery in relation to atherosclerosis of its branches. A coronary arteriographic study. Br Heart J. 1976;38:180-5.
  • Pereira da CostaSobrinho O, Dantas de Lucena J, SilvaPessoa R, et al. Anatomical study of length and branching pattern of main trunk of the left coronary artery. Morphologie. 2019;103:17-23.
  • Raut BK, Patil VN, Cherian G. Coronary artery dimensions in normal Indians. Indian Heart J. 2017;69:512-4.
  • Zhang LR, Xu DS, Liu XC, et al. Coronary artery lumen diameter and bifurcation angle derived from CT coronary angiographic image in healthy people. Zhonghua Xin Xue Guan Bing Za Zhi. 2011;39:1117-23.
There are 27 citations in total.

Details

Primary Language English
Subjects Cardiovascular Surgery
Journal Section Original Articles
Authors

Arzu Mumcu 0000-0001-9002-0352

Mesut Gitmez 0000-0003-1078-9095

Publication Date October 19, 2023
Acceptance Date August 17, 2023
Published in Issue Year 2023 Volume: 5 Issue: Supplement (1) - Innovations in Medicine and Healthcare in the 100th Year of the Republic

Cite

AMA Mumcu A, Gitmez M. Morphometric Analysis of the Left Main Coronary Truncus, Left Anterior Descending Artery, Circumflex Artery, and Intermediate Artery: Measurements of Length, Angle, and Diameter. Med Records. October 2023;5(Supplement (1):11-5. doi:10.37990/medr.1326903

17741

Chief Editors

Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Türkiye

E-mail: medrecsjournal@gmail.com

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