Influence of right coronary artery shape on TIMI frame count and lesion distribution

The shape of the right coronary artery (RCA) may vary between individuals.

The aim of this study was to investigate whether the shape of RCA has any effect on TIMI frame count (TFC), TIMI flow score, and lesion distribution length in patients with ST-elevation myocardial infarction (STEMI) caused by RCA.

The angiograms of 163 patients who applied to our hospital with STEMI caused by the RCA were included in the study. TFC's were calculated.

The patients were divided into two groups according to the geometric shape of the RCA as C (124 pts, 101 males, mean age 66.1 ± 12.3 years) or S (39 pts, 30 males, mean age 60.0 ± 10.8 years) based on the angiographic view from the left oblique position. Lesion location was significantly higher in the proximal and mid regions compared to the distal region in patients with C-RCA (p < 0.001). TFC was significantly higher in the S-RCA group (p = 0.0014). There was a statistically significant difference between the groups in terms of mean age of p = 0.003.

Lesion frequency was significantly higher in the proximal and mid regions in patients with C-RCA. TFC's were significantly higher in the S-RCA group. Longer S-RCA length compared to C-RCA and local shear stress characteristics may also explain these findings.