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Catheter Cardiovasc Interv. 2013 May;81(6):E225-36. doi: 10.1002/ccd.24510. Epub 2012 Nov 14.

Clinical validation of the new T- and Y-shape models for the quantitative analysis of coronary bifurcations: an interobserver variability study.

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Medis Medical Imaging Systems BV, Leiden, The Netherlands.



This article presents the results of an interobserver validation study of our new T- and Y-shape bifurcation models including their edge segment analyses.


Over the last years, the coronary artery intervention procedures have been developed more and more toward bifurcation stenting. Because traditional straight vessel quantitative coronary arteriography (QCA) is not sufficient for these measurements, the need has grown for new bifurcation analysis methods.


In this article, our two new bifurcation analysis models are presented, the Y-shape and T-shape model. These models were designed for the accurate measurement of the clinically relevant parameters of a coronary bifurcation, for different morphologies and intervention strategies and include an edge segment analysis, to accurately measure (drug-eluting) stent, stent edge, and ostial segment parameters.


The results of an interobserver validation study of our T-shape and Y-shape analyses are presented, both containing the pre- and post-intervention analyses of each 10 cases. These results are associated with only small systematic and random errors, in the majority of the cases compliant with the QCA guidelines for straight analyses. The results for the edge segment analyses are also very good, with almost all the values within the margins that have been set by our brachytherapy directive.


Our new bifurcation approaches including their edge segment analyses are very robust and reproducible, and therefore a great extension to the field of quantitative coronary angiography.

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