| Crush, Culotte, T and Protrusion: Which 2-Stent Technique for Treatment of True Bifurcation Lesions? | |
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MedLine Citation:
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PMID: 23006784 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background: Percutaneous coronary intervention of complex true bifurcation lesions often fails to ensure continuous stent coverage and strut apposition in both the side branch and main vessel. Struts left unopposed floating in the lumen disturb blood flow and are increasingly recognized as increasing the risk of stent thrombosis. Methods and Results: In this study, we compared the results of different bifurcation treatment strategies: Crush (n=5); Culotte (n=3); T-/T with Protrusion (TAP) (n=4) using drug-eluting stents deployed in-vitro in representative coronary bifurcation models. After final kissing balloon post-dilatation, the rate of malapposition within the bifurcation quantified from micro-computed tomography scanning was on average 41.5±8.2% with the Crush technique, reduced to respectively 31.4±5.2% with Culotte and 36.7±8.0% with T-/TAP approach. Overlaying layers of struts in the Crush and Culotte techniques lead to a significantly higher rate of strut malapposition in the proximal vessel than with the T-/TAP technique (Crush: 39.1±10.7%, Culotte: 26.1±7.7%, TAP: 4.2±7.2%, P<0.01). Maximal wall-malapposed strut distance was also found on average to be higher with the Crush (1.36±0.4mm) and Culotte techniques (1.32±0.1mm) than with T-/TAP (1.08±0.1mm, P=0.04). Conclusions: In this model, the Crush technique resulted in a higher risk of malapposition than either the Culotte or T-/TAP technique. |
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Authors:
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Nicolas Foin; Eduardo Alegria-Barrero; Ryo Torii; Pak H Chan; N Viceconte; Justin E Davies; Carlo Di Mario |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-9-25 |
Journal Detail:
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Title: Circulation journal : official journal of the Japanese Circulation Society Volume: - ISSN: 1347-4820 ISO Abbreviation: Circ. J. Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-9-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101137683 Medline TA: Circ J Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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International Centre for Circulatory Health, NHLI and Imperial College. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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