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Dynamic atrioventricular delay programming improves ventricular electrical synchronization as evaluated by 3D vectorcardiography Early Diagnosis of Myocardial Infarction With Point-of-Care High-Sensitivity Cardiac Troponin I Association Between Living in Food Deserts and Cardiovascular Risk Impact of Optimal Medical Therapy on 10-Year Mortality After Coronary Revascularization Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes The Astronaut Cardiovascular Health and Risk Modification (Astro-CHARM) Coronary Calcium Atherosclerotic Cardiovascular Disease Risk Calculator Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association Canadian Multicenter Chronic Total Occlusion Registry: Ten-Year Follow-Up Results of Chronic Total Occlusion Revascularization Long-Term Outcomes of Biodegradable Versus Second-Generation Durable Polymer Drug-Eluting Stent Implantations for Myocardial Infarction 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)
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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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