{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T15:42:32Z","timestamp":1780328552371,"version":"3.54.1"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T00:00:00Z","timestamp":1657584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To identify angiographic predictors of aberrant left circumflex artery\u00a0(LCx) by comparing left main (LM) length and bifurcation angle between patients with aberrant LCx and normal anatomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Failure to recognize aberrant LCx\u00a0during a cardiac catheterization may hamper correct diagnosis, delay intervention in acute coronary syndromes, and result in increased contrast volume, radiation exposure, and infarct size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed angiograms of aberrant LCx patients and normal anatomy matched controls, in three\u2010participating centers. LM\u2010length, bifurcation angle between the left anterior descending (LAD) and the first non\u2010LAD branch of the LM, and procedural data were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2003 and 2020, 136 patients with aberrant LCx and 135 controls were identified. More catheters (2.4\u2009\u00b1\u20090.6 vs. 2.2\u2009\u00b1\u20090.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.009), larger contrast volumes (169\u2009\u00b1\u200994\u2009ml vs. 129\u2009\u00b1\u200968\u2009ml, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0005), and prolonged fluoroscopy time (652.9\u2009\u00b1\u2009623.7\u2009s vs. 393.1\u2009\u00b1\u2009332.1\u2009s, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0005), were required in the aberrant LCx\u2010group compared with controls. Patients with aberrant LCx had a longer LM\u2010length and a more acute bifurcation angle, both in caudal and cranial views, compared with controls (24.7\u2009\u00b1\u20098.1 vs. 10.8\u2009\u00b1\u20094.5\u2009mm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0005 and 26.7\u2009\u00b1\u20097.4 vs. 12\u2009\u00b1\u20095.5\u2009mm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0005, respectively, and 45.2\u00b0\u2009\u00b1\u200912\u00b0 vs. 88.8\u00b0\u2009\u00b1\u200923\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0005 and 51.9\u00b0\u2009\u00b1\u200921\u00b0 vs. 68.2\u00b0\u2009\u00b1\u200928.3\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0005, respectively). In ROC analysis, LM\u2010length showed the best diagnostic accuracy for detecting aberrant LCx. In multiple logistic regression analysis, a cranially measured LM\u2010length\u2009&gt;\u200917.7\u2009mm was associated with a 5.3 times greater probability of predicting aberrant LCx [95%\u00a0CI (3.4\u20138.1), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study suggests that a long LM\u2010length and an acute bifurcation angle can indicate the presence of aberrant LCx. We present a practical algorithm for its rapid identification.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30322","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T11:43:45Z","timestamp":1657626225000},"page":"378-386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Angiographic predictors of aberrant circumflex artery during cardiac catheterization"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8037-463X","authenticated-orcid":false,"given":"Andreas S.","family":"Triantafyllis","sequence":"first","affiliation":[{"name":"Department of Cardiology Asklepeion General Hospital  Athens Greece"},{"name":"Department of Cardiology Catharina Hospital Eindhoven  Eindhoven The Netherlands"},{"name":"Department of Cardiovascular Medicine University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lokien X.","family":"van Nunen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Catharina Hospital Eindhoven  Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1663-373X","authenticated-orcid":false,"given":"Pierluizi","family":"Lesizza","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0189-8353","authenticated-orcid":false,"given":"Efstathios D.","family":"Pagourelias","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5863-516X","authenticated-orcid":false,"given":"Aimilianos","family":"Kalogeris","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asklepeion General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjoerd","family":"Bouwmeester","sequence":"additional","affiliation":[{"name":"Department of Cardiology Catharina Hospital Eindhoven  Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavlos","family":"Tsinivizov","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asklepeion General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestoras","family":"Kontogiannis","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asklepeion General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Giannakopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asklepeion General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonidas E.","family":"Poulimenos","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asklepeion General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8301-4517","authenticated-orcid":false,"given":"Johan","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"Teeuwen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Catharina Hospital Eindhoven  Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Kyfnidis","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asklepeion General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Desmet","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine University Hospitals Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim A. 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