Evaluation of the spatial changes of the coronary morphology due to stent implantation with three-dimensional angiography

3-Dimensional (3D) geometry of the coronary artery often changes due to stent implantation. In our investigation we analyzed the effect of stent on the 3D geometry in each heart-cycle phase. At the site of implantation the degree of decrease in the coronary curve were measured, and the correlation between the original curve and the change of the curve were determined. The effect of 17 Coroflex Blue (B. Braun) stents implantation (3.07±0.33 mm in diameter and 17.64±4.42 mm in length) in 17 patients was analyzed. The curve of the segment was characterized by either the 2D images gained from the best optimal projection (BOP) or the 3D reconstruction, measuring the distance between the line superimposed onto the midline of the stented segment (arch) and the distance of the end-points of the stented segment (chord) before an after the intervention. The difference in the ratio of arch/chord after and before the stenting showed significant correlation both at end-diastolic and end-systolic analysis with the start-off arch/chord ratio, but the diastolic correlation was slightly higher (r = 0.93, p = 2 × 10⁸ and r = 0.89, p = 6 × 10⁷ , respectively). We have experienced more than 10% growth in change of the curve at higher than 1.15 start-off arch/chord ratio. In the intervened coronary segment the change of the spatial morphology depending on the start-off curve even after flexible stent implantation.