The everolimus-eluting XIENCE side-branch access (SBA) stent has been the focus of numerous recent publications. Most of the information available on this device comes from the preclinical studies performed in ovine models as well as perfused synthetic heart models. It has now become available in Europe as part of a limited test launch. Delivered via a low-profile, dual-lumen, single-tip catheter, a single inflation device deploys the stent in the main branch and expands a portal opening into the ostium of the side branch to allow for scaffolding and entry into the side branch. This case report describes the first-in-man experience with this novel device.
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- Clinical events can occur after percutaneous coronary intervention (PCI), especially in complex cases, and using advanced intracoronary imaging and pressure guidewires may help reduce these risks.
- The OPTI-XIENCE study is an international, multicenter prospective observational study involving 1,064 patients with specific high-risk characteristics undergoing stent implantation, monitoring them for 12 months.
- The study aims to evaluate the effectiveness of using these intracoronary tools, with the primary focus on the rate of target lesion failure after one year, while also assessing additional cardiovascular outcomes.
Side-branch expansion capacity of contemporary DES platforms.
Eur J Med Res
October 2021
Institute for Implant Technology and Biomaterials-IIB E.V, Associated Institute of the University of Rostock, Warnemuende, Rostock, Germany.
Background: Percutaneous coronary interventions (PCI) of bifurcation stenoses are both complex and challenging. Stenting strategies share that the stents' side cells must be carefully explored and appropriately prepared using balloons or stents. So far, stent manufacturers have not provided any information regarding side-branch expansion capacity of their stent platforms.
View Article and Find Full Text PDFImpact of Coronary Stent Design in Proximal Balloon Edge Dilation Technique for Bifurcation Percutaneous Coronary Intervention.
Int Heart J
September 2021
Department of Cardiology, Kawasaki Medical School.
The proximal optimizing technique (POT) -proximal balloon edge dilation (PBED) sequence for side branch (SB) dilatation with cross-over single-stent implantation decreases both strut obstruction at the SB ostium and stent deformation at the main branch (MB).The purpose of this experimental bench test was to assess the impact of stent design on stent deformation, obstruction by stent struts at a jailed SB ostium, and stent strut malapposition in the POT-PBED sequence.Fractal coronary bifurcation bench models (60- and 80-degree angles) were used, and crossover single-stent implantation (3-link stent: XIENCE Sierra, Abbott Vascular, Santa Clara, CA, n = 10; 2-link stent: Synergy, Boston Scientific, Marlborough, MA, n = 10) was performed from the MB using the POT-PBED sequence.
View Article and Find Full Text PDFComparison of overexpansion capabilities and thrombogenicity at the side branch ostia after implantation of four different drug eluting stents.
Sci Rep
November 2020
National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
Interventions in bifurcation lesions often requires aggressive overexpansion of stent diameter in the setting of long tapering vessel segment. Overhanging struts in front of the side branch (SB) ostium are thought to act as a focal point for thrombi formation and consequently possible stent thrombosis. This study aimed to evaluate the overexpansion capabilities and thrombogenicity at the SB ostia after implantation of four latest generation drug-eluting stents (DES) in an in-vitro bifurcation model.
View Article and Find Full Text PDFStandardized fractal bench test evaluation of coronary stents: Performances in bifurcation lesions treated by the re-proximal optimization technique.
Catheter Cardiovasc Interv
July 2021
Department of Cardiology, Nantes University Hospital, Nantes, France.
Background: Bifurcation lesions in coronary arteries are complex to treat with coronary stents, which are not designed for that purpose and can be unproperly deployed. Moreover, devices are constantly evolving, and so are angioplasty techniques.
Objectives: The aim of this study was to determine the performances of different stents in the treatment of bifurcation lesions using the re-proximal optimization technique (rePOT).
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