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Revascularization in Patients With Left Main Coronary Artery Disease and Left Ventricular Dysfunction Extracellular Vesicles From Epicardial Fat Facilitate Atrial Fibrillation Proteomics to Improve Phenotyping in Obese Patients with Heart Failure with Preserved Ejection Fraction Single Versus Dual Antiplatelet Therapy Following TAVR: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Usefulness of intravascular ultrasound to predict outcomes in short-length lesions treated with drug-eluting stents Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main and Multivessel Coronary Artery Disease: Do We Have the Evidence? Combined use of OCT and IVUS in spontaneous coronary artery dissection Transcatheter Mitral Valve Replacement in Patients with Heart Failure and Secondary Mitral Regurgitation: From COAPT Trial Coronary Access After TAVR With a Self-Expanding Bioprosthesis: Insights From Computed Tomography Management of Antithrombotic Therapy in Atrial Fibrillation Patients Undergoing PCI: JACC State-of-the-Art Review
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Clinical Trial2018 Mar 20. pii: EIJ-D-17-00941.

JOURNAL：EuroIntervention. Article Link

Benefit of a new provisional stenting strategy: the re-Proximal Optimizing Technique. The rePOT clinical study

Dérimay F, Finet G, Souteyrand G et al. Keywords: left main bifurcation optical coherence tomography

ABSTRACT

AIMS - A new coronary bifurcation provisional stenting technique without kissing balloon, rePOT, associating proximal optimizing technique (POT), side-branch inflation and final POT, showed excellent mechanical results in a bench test. The present study sought to use optical coherence tomography (OCT) to quantify the mechanical results of rePOT in vivo in a large patient sample with complex coronary bifurcations.


METHODS AND RESULTS - 106 patients with coronary bifurcations were included in a multicenter prospective registry (left main, 40.6%; true Medina bifurcation, 39.6%). Three OCT runs were performed, at baseline, just after stent implantation and after the complete rePOT sequence, quantifying global malapposition, side-branch obstruction (SBO), and various geometric arterial criteria. RePOT was completed systematically. RePOT significantly reduced global strut malapposition from 18.9±13.4% just after stent implantation to 3.2±3.9% (p<0.05), residual SBO from 44.3±12.9% to 17.0±14.3% (p<0.05), and ellipticity index from 1.19±0.11 to 1.13±0.12 (p<0.05). Exhaustive 6-month follow-up found only 1 mother-vessel target lesion revascularization.

CONCLUSIONS - This clinical study of a large sample of complex coronary bifurcations with OCT analysis showed the benefit of the rePOT sequence in provisional stenting, replicating in vivo the excellent in vitro geometric results previously reported, and confirming ease of implementation and medium-term safety.
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