Document Detail

Crush, culotte, T and protrusion: which 2-stent technique for treatment of true bifurcation lesions? - insights from in vitro experiments and micro-computed tomography.
MedLine Citation:
PMID:  23006784     Owner:  NLM     Status:  MEDLINE    
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.
Nicolas Foin; Eduardo Alegria-Barrero; Ryo Torii; Pak H Chan; N Viceconte; Justin E Davies; Carlo Di Mario
Related Documents :
9155614 - Prognostic significance of right ventricular afterload stress detected by echocardiogra...
17531514 - Pulmonary embolism after operative treatment of proximal humeral fractures.
15684354 - Screening for pulmonary embolism with a d-dimer assay: do we still need to assess clini...
2920564 - Whole lung pulmonary angiography in the intensive care unit with two portable chest x-r...
21731564 - Effect of a dual drug-coated stent with abciximab and alpha-lipoic acid in a porcine co...
20461114 - Arterial distensibility in chronic inflammatory rheumatic disorders.
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-09-25
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  77     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-07     Completed Date:  2013-06-13     Revised Date:  2013-07-08    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  73-80     Citation Subset:  IM    
International Centre for Circulatory Health, NHLI and Imperial College, London.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Drug-Eluting Stents*
Models, Cardiovascular*
Percutaneous Coronary Intervention / adverse effects,  methods*
X-Ray Microtomography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Hyperoxia changes the balance of the thioredoxin/peroxiredoxin system in the neonatal rat brain.
Next Document:  An investigation into the knowledge and attitudes towards radon testing among residents in a high ra...