Sequential coronary bifurcation revascularization with the Xposition S™ self-apposing stent: a comparative fractal bench study

Dérimay, François; Maillard, Luc; Rioufol, Gilles; Aminian, Adel; Véziers, Joëlle; Guérin, Patrice; Finet, Gérard

doi:10.1007/s00380-019-01460-8

Cited by 3 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In clinical practice, BES bifurcation revascularization requires systematic initial POT [ 7 , 13 ] to correct the expected proximal malapposition [ 6 ]. Nitinol SAS experimentally demonstrated perfect spontaneous apposition in provisional stenting without need for specific bifurcation post-dilatation such as POT [ 9 ], and in contrast to balloon-expandable stents [ 7 ]. This may be useful in limiting the risk of embolization in the bench model.…”

Section: Discussionmentioning

confidence: 99%

“…But, in the specific context of pPCI, POT, like any post-dilatation, risks distal thrombus embolization in the branches. The mechanical properties of nitinol self-apposing stents (SAS) may, in bifurcation pPCI, enable spontaneous correction of proximal malapposition [ 8 ] without for need for POT [ 9 ], in contrast to balloon-expandable stent (BES) [ 10 ]. To date, all strategies to decrease thrombus burden before pPCI, whether mechanical thrombo-aspiration [ 11 ] or pharmacological resorption as minimalist immediate mechanical intervention (MIMI) strategy [ 12 ], failed to improve the clinical prognosis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Thrombus burden management during primary coronary bifurcation intervention: a new experimental bench model

Hayek¹,

Dargaud²,

Maillard³

et al. 2024

Cardiol J.

View full text Add to dashboard Cite

Background Management of thrombus burden during primary percutaneous coronary intervention (pPCI) is a key-point, given the high risk of stent malapposition and/or thrombus embolization. These issues are especially important if pPCI involves a coronary bifurcation. Herein, a new experimental bifurcation bench model to analyze thrombus burden behavior was developed. Methods On a fractal left main bifurcation bench model, we generated standardized thrombus with human blood and tissue factor. Three provisional pPCI strategies were compared (n = 10/group): 1) balloon-expandable stent (BES), 2) BES completed by proximal optimizing technique (POT), and 3) nitinol self-apposing stent (SAS). The embolized distal thrombus after stent implantation was weighed. Stent apposition and thrombus trapped by the stent were quantified on two-dimensional-optical coherence tomography (OCT). To analyze final stent apposition, a new OCT acquisition was performed after pharmacological thrombolysis. Results Trapped thrombus was significantly greater with isolated BES than SAS or BES+POT (18.8 ± 5.8% vs. 10.3 ± 3.3% and 6.2 ± 2.1%, respectively; p < 0.05), and greater with SAS than BES+POT (p < 0.05). Isolated BES and SAS tended show less embolized thrombus than BES+POT (5.93 ± 4.32 mg and 5.05 ± 4.56 mg vs. 7.01 ± 4.32 mg, respectively; p = NS). Conversely, SAS and BES+POT ensured perfect final global apposition (0.4 ± 0.6% and 1.3 ± 1.3%, respectively, p = NS) compared to isolated BES (74.0 ± 7.6%, p < 0.05). Conclusions This first experimental bench model of pPCI in a bifurcation quantified thrombus trapping and embolization. BES provided the best thrombus trapping, while SAS and BES+POT achieved better final stent apposition. These factors should be taken into account in selecting revascularization strategy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Thrombus burden management during primary coronary bifurcation intervention: a new experimental bench model

Hayek¹,

Dargaud²,

Maillard³

et al. 2024

Cardiol J.

View full text Add to dashboard Cite

show abstract

Current clinical applications and potential perspective of micro-computed tomography in cardiovascular imaging: A systematic scoping review

Papazoglou

Karagiannidis

Moysidis

et al. 2021

Hellenic Journal of Cardiology

View full text Add to dashboard Cite

Volumetric Tissue Imaging of Surgical Tissue Specimens Using Micro–Computed Tomography: An Emerging Digital Pathology Modality for Nondestructive, Slide-Free Microscopy—Clinical Applications of Digital Pathology in 3 Dimensions

Papazoglou

Karagiannidis

Liatsos

et al. 2022

American Journal of Clinical Pathology

View full text Add to dashboard Cite

Objectives Micro–computed tomography (micro-CT) is a novel, nondestructive, slide-free digital imaging modality that enables the acquisition of high-resolution, volumetric images of intact surgical tissue specimens. The aim of this systematic mapping review is to provide a comprehensive overview of the available literature on clinical applications of micro-CT tissue imaging and to assess its relevance and readiness for pathology practice. Methods A computerized literature search was performed in the PubMed, Scopus, Web of Science, and CENTRAL databases. To gain insight into regulatory and financial considerations for performing and examining micro-CT imaging procedures in a clinical setting, additional searches were performed in medical device databases. Results Our search identified 141 scientific articles published between 2000 and 2021 that described clinical applications of micro-CT tissue imaging. The number of relevant publications is progressively increasing, with the specialties of pulmonology, cardiology, otolaryngology, and oncology being most commonly concerned. The included studies were mostly performed in pathology departments. Current micro-CT devices have already been cleared for clinical use, and a Current Procedural Terminology (CPT) code exists for reimbursement of micro-CT imaging procedures. Conclusions Micro-CT tissue imaging enables accurate volumetric measurements and evaluations of entire surgical specimens at microscopic resolution across a wide range of clinical applications.

show abstract

Sequential coronary bifurcation revascularization with the Xposition S™ self-apposing stent: a comparative fractal bench study

Cited by 3 publications

References 7 publications

Thrombus burden management during primary coronary bifurcation intervention: a new experimental bench model

Thrombus burden management during primary coronary bifurcation intervention: a new experimental bench model

Current clinical applications and potential perspective of micro-computed tomography in cardiovascular imaging: A systematic scoping review

Volumetric Tissue Imaging of Surgical Tissue Specimens Using Micro–Computed Tomography: An Emerging Digital Pathology Modality for Nondestructive, Slide-Free Microscopy—Clinical Applications of Digital Pathology in 3 Dimensions

Contact Info

Product

Resources

About