Percutaneous coronary intervention for coronary bifurcation lesions has been associated with lower procedural success rates and worse clinical outcome compared with nonbifurcation lesions in the bare stent era (1). However, after the introduction of drug-eluting stents, extremely low rates of in-stent restenosis have been observed (2). Following several randomized controlled studies have indicated that coronary bifurcation lesions may be optimally treated using the optional side branch stenting strategy and the clinical outcomes after simple optional side branch stenting remained at least equal to the more...

Phantom Preparation A silicon coronary artery phantom simulating main branch (MB) and side branch (SB) was prepared using a 3-D printer (Projet 3510 SD). An angle between MB and SB was 45 degree and wall thickness of the phantom was 1 mm. The MB diameter was 4.5 mm tapering to 3.5 mm and the SB diameter was 3.0 mm. Bifurcation stenting was performed by an experienced interventional cardiologist (Y.H.K, 8 years of experience) using a drug eluting stent (Sience Prime, Abbott). Crush, Cullotte, and T-stenting...

Phantom Crushed segment appeared as denser and thicker than non-crushed segment on dual source CT at the junction of MB and SB stent on either side (figure 2). Floating strut appeared as protruding of the stent on dual source CT (figure 2). The classification of the location of crushed segment, presence of floating strut and unintended gap matched between micro-CT and dual source CT. Among 9 stents, 8 (89%) were central type, 4 (44%) had floating strut and 2 (22%) showed unintended gap. Parameters measured...

The major findings of the study were 1) post-bifurcation stent morphology could be demonstrated on dual source CT which correlated well with micro-CT findings 2) Unexpected findings such as floating strut (44%), unintended gap (22%) and the eccentric location (11%) of crushed segment was observed in post-bifurcation stents. Several bench studies have demonstrated post-bifurcation stent morphology including crushed struts, jailed SB ostium, or gaps in stent coverage using micro-CT (16-18). Also, intravascular ultrasound and optical computed tomography have been widely used to visualize morphological characteristics...

1. Latib A, Colombo A, Sangiorgi GM. Bifurcation stenting: current strategies and new devices. Heart 2009;95:495-504. 2. Moses JW, Leon MB, Popma JJ et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 2003;349:1315-23. 3. Jensen JS, Galloe A, Lassen JF et al. Safety in simple versus complex stenting of coronary artery bifurcation lesions. The nordic bifurcation study 14-month follow-up results. EuroIntervention 2008;4:229-33. 4. Maeng M, Holm NR, Erglis A et al. Long-term results after...