Crush, culotte, T and protrusion: which 2-stent technique for treatment of true bifurcation lesions? insights from in vitro experiments and micro-computed tomography

DOI Web Site PubMed 被引用文献2件 参考文献36件
  • Foin Nicolas
    International Centre for Circulatory Health, NHLI and Imperial College
  • Alegria-Barrero Eduardo
    NIHR Cardiovascular BRU, Royal Brompton & Harefield NHS Trust
  • Torii Ryo
    International Centre for Circulatory Health, NHLI and Imperial College
  • Chan Pak H.
    NIHR Cardiovascular BRU, Royal Brompton & Harefield NHS Trust
  • Viceconte N.
    NIHR Cardiovascular BRU, Royal Brompton & Harefield NHS Trust
  • Davies Justin E.
    International Centre for Circulatory Health, NHLI and Imperial College
  • Di Mario Carlo
    NIHR Cardiovascular BRU, Royal Brompton & Harefield NHS Trust

書誌事項

タイトル別名
  • Crush, Culotte, T and Protrusion: Which 2-Stent Technique for Treatment of True Bifurcation Lesions?
  • – Insights From In Vitro Experiments and Micro-Computed Tomography –

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Background: Percutaneous coronary intervention of complex true bifurcation lesions often fails to ensure continuous stent coverage and strut apposition in both the side branch and main vessel. Struts left unopposed floating in the lumen disturb blood flow and are increasingly recognized as increasing the risk of stent thrombosis. Methods and Results: In this study, we compared the results of different bifurcation treatment strategies: Crush (n=5); Culotte (n=3); T-/T with Protrusion (TAP) (n=4) using drug-eluting stents deployed in-vitro in representative coronary bifurcation models. After final kissing balloon post-dilatation, the rate of malapposition within the bifurcation quantified from micro-computed tomography scanning was on average 41.5±8.2% with the Crush technique, reduced to respectively 31.4±5.2% with Culotte and 36.7±8.0% with T-/TAP approach. Overlaying layers of struts in the Crush and Culotte techniques lead to a significantly higher rate of strut malapposition in the proximal vessel than with the T-/TAP technique (Crush: 39.1±10.7%, Culotte: 26.1±7.7%, TAP: 4.2±7.2%, P<0.01). Maximal wall-malapposed strut distance was also found on average to be higher with the Crush (1.36±0.4mm) and Culotte techniques (1.32±0.1mm) than with T-/TAP (1.08±0.1mm, P=0.04). Conclusions: In this model, the Crush technique resulted in a higher risk of malapposition than either the Culotte or T-/TAP technique.  (Circ J 2013; 77: 73–80)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 77 (1), 73-80, 2013

    一般社団法人 日本循環器学会

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