CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Impact of stent deformity induced by the kissing balloon technique for bifurcating lesions on in-stent restenosis after coronary intervention Multicenter Registry of Real-World Patients With Severely Calcified Coronary Lesions Undergoing Orbital Atherectomy: 1-Year Outcomes Treating Bifurcation Lesions: The Result Overcomes the Technique Optical Coherence Tomography to Assess Proximal Side Optimization Technique in Crush Stenting The Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention: Update From the PROGRESS CTO Registry Bare metal or drug-eluting stent versus drug-coated balloon in non-ST-elevation myocardial infarction: the randomised PEPCAD NSTEMI trial Chronic Total Occlusion Interventions: Update on Current Tips and Tricks Percutaneous coronary interventional strategies for treatment of in-stent restenosis: a network meta-analysis Randomized study on simple versus complex stenting of coronary artery bifurcation lesions: the Nordic bifurcation study The European bifurcation club Left Main Coronary Stent study: a randomized comparison of stepwise provisional vs. systematic dual stenting strategies (EBC MAIN)

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.