Luminal eccentricity and deformity in atherosclerotic coronary arteries

Detailed analyses of the configuration of lumina from one hundred (100) segments of severely atherosclerotic epicardial coronary arteries (at least 75 p. 100 of the area of their original lumina narrowed, determined by planimetry) were made. All lumina were distended by a standardized coronary injection technique. In contrast to the general impression, concentric lumina occurred as commonly as eccentric lumina and there were more arteries with an eccentric lumen and/or with significant luminal deformity, i.e. with their smallest diameter smaller than 50 p. 100 of their greatest diameter, than the concentric and more regular ones. The eccentricity and significant deformity of atherosclerotic lumina apparently cause difficulties in precise angiographic measurements of coronary stenosis. To solve the problem of the discrepancies between angiographic and anatomical estimation of coronary arterial stenosis, utilization of more than three different projection angles should be considered in clinical angiographic appraisal.