CBS 2019
CBSMD教育中心
中 文

分叉支架

Abstract

Recommended Article

Double kissing crush in left main coronary bifurcation lesions: A crushing blow to the rival stenting techniques Coronary bifurcation lesions treated with simple or complex stenting: 5-year survival from patient-level pooled analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions Active SB-P Versus Conventional Approach to the Protection of High-Risk Side Branches: The CIT-RESOLVE Trial Impact of bifurcation technique on 2-year clinical outcomes in 773 patients with distal unprotected left main coronary artery stenosis treated with drug-eluting stents In vitro flow and optical coherence tomography comparison of two bailout techniques after failed provisional stenting for bifurcation percutaneous coronary interventions The Comparison of Clinical Outcomes After Drug-Eluting Balloon and Drug-Eluting Stent Use for Left Main Bifurcation In-Stent Restenosis Bench testing and coronary artery bifurcations: a consensus document from the European Bifurcation Club

Original Research2020 Apr 28.

JOURNAL:Eurointervention. Article Link

Double-Kissing Culotte Technique for Coronary Bifurcation Stenting - Technical evaluation and comparison with conventional double stenting techniques

GG Toth, V Sasi; D Franco et al. Keywords: technique improvement; culotte technique

ABSTRACT

AIMS - To assess, whether Culotte technique could be improved by an additional kissing dilation prior main branch (MB) stenting.

 

METHODS AND RESULTS - Double-kissing (DK) Culotte was compared to Culotte and DK-Crush techniques in bench model (n=24). Results were evaluated for stent apposition, for luminal opening and for flow dynamics.Total procedure duration of DK-Culotte was 18.3±3.4min, significantly lower than for DK-Crush (24.3±5.7min; p=0.015), however similar to Culotte (21.6±5.9min, p=0.104).In DK-Culotte overall rate of moderate (200-500mm) and significant (>500mm) malapposition was 2.1±1.9% and 0.4±0.2%; similar as compared to Culotte (3.7±3.8%, p=0.459 and 1.0±1.0%, p=0.517; respectively), and lower as compared to DK-Crush (8.1±2.5%, p<0.001 and 3.7±5.3%, p=0.002; respectively). Lower malapposition rate of DK-Culotte as compared to DK-Crush was due to less moderate and significant malapposition in proximal MB (0.0±0.0% vs. 14.0±7.6%, p<0.001 and 0.0±0.0% vs. 4.2±9.1%, p=0.026, respectively). Micro computed tomography did not show difference in luminal opening at proximal MB, distal MB or SB. There was no difference either in maximum shear rate or in areas of high shear or recirculation.

 

CONCLUSIONS - Bench tests data suggest that DK approach facilitates Culotte technique. Clinical validity and relevance remains to be confirmed in larger in vivo population.