Double kissing mini-culotte versus mini-culotte stenting: insights from micro-computed tomographic imaging of bench testing

Abstract

Aims: This study aimed to evaluate the morphologic characteristics of double kissing (DK) mini-culotte and mini-culotte stenting through imaging of bench testing.Methods and results: DK mini-culotte and mini-culotte stenting were performed in two silicone bifurmini-culotte group. The results of factorial analysis showed that maximum distance of malapposed struts F Conclusions: Compared with mini-culotte stenting, DK mini-culotte stenting was associated with shorter metal carina length, shorter maximum distance of malapposed struts, and smaller SBO area stenosis. Thus, DK mini-culotte stenting may obtain better morphologic characteristics.

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

“…This polymeric BVS represents vessel patency and then to vanish resulting in a promising therapeutic strategy, named vascular restoration therapy(Refer to Figure 1 for the speci c process). The three differents culottebased stenting techniques: conventional culotte stenting (CCS, n=10) (Figure 2) Video 1 ; double kissing mini-culotte stenting (DKMCS, n=10) (Figure 3) Video 2 and double kissing single-ring culottes stenting (DKSRCS, n=10) (Figure 4) Video 3 were performed using previously reported methods in LePu Medical centralab 7 . BVS of 3.5 mm and 3.0 mm was used to stent the MB and SB, respectively.…”

“…Although various Culotte-based stenting techniques (CSTs) exist, the ideal one remains undetermined. Bench testing using bifurcated coronary artery models can provide insights into stent morphologies and differences among CSTs, such as Conventional culotte stenting (CCS), double kissing miniculotte stenting (DKMCS), and double kissing single-ring culotte stenting (DKSRCS) using BVS, in terms of stent expansion and coverage across different bifurcation anatomies 6,7 .…”

Fundamentals of percutaneous coronary bifurcation interventions

“…The DMV should be wired from the closest cell to the carina for the reasons described above (Figure 11D ); (5) Stent struts are opened by a DMV balloon. Instead, KBI, which is part of the recently introduced “DK-culotte technique”, can be performed[ 89 , 90 ] (Figure 11E ). This technique was found to achieve better morphological properties than classical culotte stenting in a bench test study[ 89 ], and it reduced the total procedural time with better strut apposition than the culotte and even the DK-crush techniques in another study[ 90 ]; (6) An MV stent sized 1:1 to the DMV diameter is advanced and implanted.…”

“…Instead, KBI, which is part of the recently introduced “DK-culotte technique”, can be performed[ 89 , 90 ] (Figure 11E ). This technique was found to achieve better morphological properties than classical culotte stenting in a bench test study[ 89 ], and it reduced the total procedural time with better strut apposition than the culotte and even the DK-crush techniques in another study[ 90 ]; (6) An MV stent sized 1:1 to the DMV diameter is advanced and implanted. The length of the PMV part should be sufficient to cover the PMV part of the SB and be at least equal to the shortest POT balloon (Figure 11F ); (7) A second POT is performed in the PMV (Figure 11G ); (8) A second wire exchange is performed by passing the MV wire through the closest cell to the carina into the SB and the U-shaped SB wire into the DMV (Figure 11H ); (9) KBI is performed with short non-compliant balloons sized 1:1 to the branches.…”

Chinese Guideline for Percutaneous Coronary Intervention in Patients with Left Main Bifurcation Disease

“…[39] More recently, a chain of modified Culotte stenting has been proposed, mainly including mini-Culotte [40] and double-kissing culotte (DK Mini-Culotte). [41,42] DK Mini-culotte for true bifurcation lesions is superior to PS in the reduction of target lesion revascularization (TLR)/target vessel revascularization (TVR) and SB restenosis, and the treatment effect of those 2 modified culotte stenting is comparable to other 2-stent techniques. [42,43] Nevertheless, randomized controlled trials are needed to warrant the efficacy of modified culotte stenting.…”