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The Role of Vascular Imaging in Guiding Routine Percutaneous Coronary Interventions: A Meta-Analysis of Bare Metal Stent and Drug-Eluting Stent Trials Suture- or Plug-Based Large-Bore Arteriotomy Closure: A Pilot Randomized Controlled Trial Coronary calcification in the diagnosis of coronary artery disease From Focal Lipid Storage to Systemic Inflammation Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction Primary Prevention of Sudden Cardiac Death Is Cardiac Diastolic Dysfunction a Part of Post-Menopausal Syndrome? Association of Cardiovascular Disease With Respiratory Disease Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction The Prevalence of Myocardial Bridging Associated with Coronary Endothelial Dysfunction in Patients with Chest Pain and Non-Obstructive Coronary Artery Disease
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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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