Location of side branch access critically affects results in bifurcation stenting: Insights from bench modeling and computational flow simulation.
Int J Cardiol
; 168(4): 3623-8, 2013 Oct 09.
Article
de En
| MEDLINE
| ID: mdl-23714592
ABSTRACT
BACKGROUND:
The aim of this study was to evaluate the impact of stent design and side branch access on final strut apposition during bifurcation stenting. METHODS ANDRESULTS:
A series of 6 different commercially available Drug Eluting Stents (DES) (n=42) were deployed in an identical model of a coronary bifurcation. Kissing Balloon (KB) optimization was performed after either proximal or distal recrossing of the guidewire and results were analyzed by micro-Computed-Tomography. Stent design only had a minor impact on side branch lumen area free of stent struts. Similar rate of strut malapposition was observed within the bifurcation when a consistent KB optimization protocol and an optimal distal recrossing of the wire to reaccess the side branch (SB) are followed. Conversely, proximal instead of distal cell recrossing toward the side branch produced a significant lower area of the side branch lumen free of struts than an optimal distal recrossing (60.3±7.1% versus 81.1±8.0%, p<0.0001), as well as a higher rate of strut malapposed toward the SB ostium (40.6±6.0% versus 26.0±5.7%, p=0.0005).CONCLUSIONS:
Optimal cell recrossing of the guidewire may be critical to ensure successful stent optimization in bifurcation PCI.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Vitesse du flux sanguin
/
Simulation numérique
/
Conception d'appareillage
/
Endoprothèses à élution de substances
/
Modèles cardiovasculaires
Type d'étude:
Prognostic_studies
Langue:
En
Journal:
Int J Cardiol
Année:
2013
Type de document:
Article