Branch ostial optimization treatment and optimized provisional t-stenting with polymeric bioresorbable scaffolds

Cai, Wei; Chen, Lianglong; Zhang, Linlin; Tu, Shengxian; Lin, Fan; Chen, Zhaoyang; Luo, Yun; Zheng, Xuelian

doi:10.1097/md.0000000000012972

Cited by 5 publications

(8 citation statements)

References 50 publications

(40 reference statements)

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“…All interventional procedures were performed as previously described and shown in Supplementary Material ( Supplementary material S1 and Videos S1, S2 ) ( 10 , 16 , 17 ). The proximal optimizing technique (POT) was conducted in the two-stent strategy ( 18 , 19 ). The stents were mainly selected from Resolute (Medtronic Cardiovascular, Santa Rosa, CA, USA), Xience V (Abbott Vascular, Santa Clara, CA, USA), Firebird-2 (Microport Co., Shanghai, China), and Excel (JW Medical System, Weihai, China).…”

Section: Methodsmentioning

confidence: 99%

Five-year outcomes of double kissing mini-culotte stenting vs. mini-culotte stenting using drug-eluting stents for the treatment of true coronary bifurcation lesions

Tu,

Zhang,

Tian

et al. 2024

Front. Cardiovasc. Med.

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ObjectiveThis study aimed to compare the clinical outcomes of double kissing mini-culotte (DKMC) stenting with those of mini-culotte (MC) stenting in treating patients with true coronary bifurcation lesions (CBLs) in the clinical real world.MethodsThis retrospective observational cohort study included 180 consecutive patients with true CBLs (Medina type 1,1,1; 1,0,1; 0,1,1). All eligible patients underwent coronary angiography and percutaneous coronary intervention with two-stent techniques in our hospital; among them, 97 received DKMC treatment and 83 MC treatment. The primary clinical endpoints were the major adverse cardiovascular events (MACE), which included cardiac death, myocardial infarction, and target vessel/lesion revascularization (TVR/TLR). The secondary endpoints were stent thrombosis, in-stent restenosis, and individual components of MACE.ResultsQuantitative coronary angiography analysis (at 5 years) revealed that late lumen loss (0.25 ± 0.41 mm vs. 0.14 ± 0.32 mm, P = 0.032) and segmental diameter restenosis of the side branch (27.84 ± 12.34% vs. 19.23 ± 9.76%, P = 0.016) were lower in the DKMC treatment group than that in the MC treatment group. Notably, compared to that in the MC treatment group, the cumulative event rate of MACE at 5 years (22.8% vs. 8.3%, P = 0.007) and TVR/TLR (17.7% vs. 6.3%, P = 0.018) was higher in the DKMC treatment group, driven mainly by TVR/TLR. Especially, the DKMC group was related to a significant reduction in the primary and secondary endpoints in high-risk patients.ConclusionDKMC treatment was associated with less late lumen loss and restenosis in the side branch and a lower rate of cumulative MACE and TVR/TLR. DKMC treatment is more effective for treating true CBLs than MC treatment; however, these findings warrant further confirmation through a randomized clinical trial.

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Section: Methodsmentioning

confidence: 99%

Five-year outcomes of double kissing mini-culotte stenting vs. mini-culotte stenting using drug-eluting stents for the treatment of true coronary bifurcation lesions

Tu,

Zhang,

Tian

et al. 2024

Front. Cardiovasc. Med.

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“…OCT was used to examine scaffold malapposition in each defaulted segment, which was calculated as described previously 10,11 a and graded as: 1) full apposition (no malapposition), 2) incomplete apposition (malapposition >160um), 3) marked malapposition (malapposition >200um), and 4) oating struts (malapposition >500um).…”

Section: Stent Deformation Indexmentioning

confidence: 99%

“…Lip-like strut area (LSA): LSA was calculated as follows: LSA = (BOA -OEA), where the redundant lip-like struts originated from the MB struts crossing over the SB ostium, which were overturned by FKBD but incompletely apposed to the upper side of the SB ostium, occupying the partial SB ostium. The area of stenosis of the ostium was calculated as LSA/BOA (Figure 4B) 10,11 .…”

Section: Openness Index Of Branch Ostiummentioning

confidence: 99%

Improving Bifurcated Scaffold Morphologies: The Feasibility of Culotte Techniques with Bioresorbable Vascular Scaffolds

Tu,

Zhang,

Tian

et al. 2024

Preprint

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Objectives: This study aimed to assess the bioresorbable vascular scaffold (BVS) performance with culotte stenting techniques and evaluate bifurcated scaffold morphologies. Methods: Conventional culotte stenting (CCS), double kissing mini-culotte stenting (DKMCS), and double kissing single-ring culotte stenting (DKSRCS) were executed in silicone bifurcated models. Procedures concluded with final kissing balloon inflation and proximal optimization technique. Microcomputed tomography assessed morphological parameters like side branch (SB) residual ostial stenosis and neocarina length (LNC) quantitatively. Optical coherence tomography (OCT) measured strut malapposition rates (SMR). Results: Quantitative assessments showed that BVS, in comparison with CCS, had significantly enhanced scaffold expansion at the SB ostium (6.29 ± 0.36 mm2 vs 6.71 ± 0.37 mm2, P = 0.05; 6.29 ± 0.36 mm2 vs 6.78 ± 0.26 mm2, P = 0.05, respectively), and decreased SB ostial stenosis(0.14% ± 0.04% vs 0.08% ± 0.04%, P < 0.05; 0.14% ± 0.04% vs 0.08 ± 0.03%, P < 0.05, respectively), LNC (0.49 ± 0.10 mm vs 0.30 ± 0.08 mm, P < 0.05; 0.49 ± 0.10 mm vs 0. 28 ± 0.06 mm, P < 0.05, respectively) and gap width(1.48 ± 0.06 mm vs 1.21 ± 0.06 mm, P < 0.05; 1.48 ± 0.06 mm vs 1.10 ± 0.04 mm, P < 0.05, respectively) in both DKMCS and DKSRCS. Notably, DKMCS and DKSRCS demonstrated reduced SMR, especially in scaffold overlap areas, as revealed by OCT. Conclusions: DKMCS and DKSRCS offer superior morphological outcomes for BVS models than CCS, suggesting BVS as a viable and effective technique for culotte stenting.

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“…Методики стентирования с применением двух стентов были разработаны с целью улучшения ангиографического результата как в ГВ, так и в БВ. Однако из-за наличия различных областей с двойным слоем страт каждая двухстентовая техника оказывает определенное влияние на локальную гемодинамику [50,51].…”

Section: влияние техники стентированияunclassified

Features of local hemodynamics and the formation of atherosclerotic lesions in coronary artery bifurcation

Khelimskii¹,

Бадоян²,

Эралиев³

et al. 2020

Russ J Cardiol

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Процесс формирования атеросклеротической бляшки в коронарных артериях носит сложный, многофакторный характер, зависящий не только от традиционных факторов риска сердечно-сосудистых заболеваний, но и от особенностей локальной гемодинамики. Атеросклеротические бляшки часто возникают в области бифуркации артерий -там, где кровоток неравномерен. В таких условиях пристеночное напряжение сдвига становится ключевым фактором развития, распространения и прогрессирования атеросклеротической бляшки. Кроме того, ряд факторов, как индивидуальная геометрия бифуркации, имплантация коронарного стента, техника имплантации могут существенно влиять на показатели напряжения сдвига и тем самым влиять на патофизиологию коронарного атеросклероза.

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Branch ostial optimization treatment and optimized provisional t-stenting with polymeric bioresorbable scaffolds

Abstract: Supplemental Digital Content is available in the text

Cited by 5 publications

References 50 publications

Five-year outcomes of double kissing mini-culotte stenting vs. mini-culotte stenting using drug-eluting stents for the treatment of true coronary bifurcation lesions

Five-year outcomes of double kissing mini-culotte stenting vs. mini-culotte stenting using drug-eluting stents for the treatment of true coronary bifurcation lesions

Improving Bifurcated Scaffold Morphologies: The Feasibility of Culotte Techniques with Bioresorbable Vascular Scaffolds

Features of local hemodynamics and the formation of atherosclerotic lesions in coronary artery bifurcation

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