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Management of two major complications in the cardiac catheterisation laboratory: the no-reflow phenomenon and coronary perforations Advances in Coronary No-Reflow Phenomenon-a Contemporary Review Optimal Stenting Technique for Complex Coronary Lesions Intracoronary Imaging-Guided Pre-Dilation, Stent Sizing, and Post-Dilation A Randomized Trial to Assess Regional Left Ventricular Function After Stent Implantation in Chronic Total Occlusion The REVASC Trial A Randomized Trial Comparing the NeoVas Sirolimus-Eluting Bioresorbable Scaffold and Metallic Everolimus-Eluting Stents Homeostatic Chemokines and Prognosis in Patients With Acute Coronary Syndromes Better Prognosis After Complete Revascularization Using Contemporary Coronary Stents in Patients With Chronic Kidney Disease Association of Thrombus Aspiration With Time and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction: A Post Hoc Analysis of the Randomized TOTAL Trial Long-Term Effect of Ultrathin-Strut Versus Thin-Strut Drug-Eluting Stents in Patients With Small Vessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Subgroup Analysis of the BIOSCIENCE Randomized Trial Management of Patients With NSTE-ACS: A Comparison of the Recent AHA/ACC and ESC Guidelines
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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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