Learning objectives
To highlight associations between geometric features of coronary arteries and the extent of atherosclerosis, presenting data from interventional coronary angiography (ICA) and coronary computed tomographic angiography (CCTA) studies.
To define parameters used for the description of coronary artery geometry and show examples of measurements.
To discuss the clinical significance of geometric parameters and implications on imaging technique and reporting.
Background
The term “cardiovascular disease” refers to atherosclerosis of coronary and other arterial systems, along with its subsequent effects on the heart. Coronary atherosclerosis is the first cause of mortality in western countries. In Greece, it is estimated that coronary disease entails mortality of 110 deaths per 100.000 people and 16.000 new cases of stable angina annually.[1]
Atherosclerosis predisposing factors would be expected to result in a diffuse and uniform vascular wall thickening, although plaques tend to occur near the origins of arterial branches or in...
Findings and procedure details
Technical considerations on the description of coronary arteries geometry
Nowadays, with the current imaging tools, the target of ongoing research is to directly correlate vascular geometry with the extent of atherosclerosis using CCTA or DSA. Whichever geometric method is to be used, it should be: easy, quick, easily incorporated into everyday clinical practice and widely accepted by CCTA reporting physicians and clinicians.
In an angiographic study of autopsy hearts, it was attempted to define coronary variations [7], using pairs of projection angiograms with focus on...
Conclusion
Coronary atherosclerosis constitutes a modern pandemic with significant morbidity and mortality. Atherosclerotic plaques tend to affect particular points of the vascular tree as a result of the effect of local geometric features to the occurrence and progression of atherosclerosis, in addition to the systemic factors. Many aspects of this influence still require definitive answers, including which modality should be used (angiography vs CCTA), whether dynamic or static measurements should be made, which exact parameters among the numerous reported should be used and to which exact...
Personal information and conflict of interest
V. Rafailidis:
Nothing to disclose
G. Rampidis:
Nothing to disclose
K. Kouskouras:
Nothing to disclose
A. Davidhi:
Nothing to disclose
A. PAPACHRISTODOULOU:
Nothing to disclose
G. Giannakoulas:
Nothing to disclose
H. Karvounis:
Nothing to disclose
P. K. Prassopoulos:
Nothing to disclose
References
1. Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferovic PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. 2019. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 40: 87-165
2. Friedman MH, Deters OJ, Mark FF, Bargeron CB, Hutchins GM. 1983. Arterial geometry affects hemodynamics. A potential risk factor for athersoclerosis. Atherosclerosis 46: 225-31
3. Svindland A....