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.
Aims: Given that drug-eluting stent (DES) information regarding their mechanical capacity of side-branch expansion is not available, we aimed to evaluate contemporary DES (Orsiro, BIOTRONIK AG; Xience Sierra, Abbott Vascular; Resolute Integrity, Medtronic; Promus Premier Select, Boston Scientific; Supraflex Cruz, Sahajan and Medical Technologies) by their side-branch expansion behavior using in vitro bench testing.
Methods: In this in vitro study, we analyzed five commercially available DES (diameter 3.0 mm), measuring their side-branch expansion following inflation of different high-pressure non-compliant (NC) balloons (balloon diameter: 2.00-4.00 mm), thereby revealing the morphological characteristics of their side-branch expansion capacities.
Results: We demonstrated that all tested contemporary DES platforms could withstand large single-cell deformations, up to 4.0 mm. As seen in our side-branch experiments, DES designs consisting of only two connectors between strut rings did not only result in huge cell areas, but also in larger cell diameters following side-branch expansion compared with DES designs using three or more connectors. Furthermore, the stent cell diameter attained was below the balloon diameter at normal pressure.
Conclusions: We recommend that the expansion capacity of side-branches should be considered in stent selection for bifurcation interventions.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507243 | PMC |
http://dx.doi.org/10.1186/s40001-021-00595-7 | DOI Listing |
Am J Cardiol
October 2024
Department of Cardiology, G.B. Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
Rev Port Cardiol
December 2024
Unidade de Cardiologia de Intervenção, Hospital de Faro, Centro Hospitalar Universitário do Algarve, Faro, Portugal.
Introduction And Objectives: Percutaneous coronary intervention (PCI) of severely calcified lesions is associated with a higher risk of procedural complications, suboptimal stent expansion, and in-stent restenosis. Lesion preparation with orbital atherectomy (OA) in severely calcified lesions has been shown to increase procedural success and decrease reintervention rates. In this study, we sought to report the procedural safety and efficacy of our initial experience with OA in a non-surgical center in Portugal.
View Article and Find Full Text PDFAnn Vasc Surg
July 2024
Division of Vascular Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.
Catheter Cardiovasc Interv
January 2024
Department of Cardiology, Army Institute of Cardiothoracic Sciences (AICTS), Pune, India.
Background: Among the two stent strategies, contemporary evidence favors double kissing crush technique (DKC) for complex unprotected distal left main bifurcation (UdLMB) lesions. However one of the major challenges to these lesions is side branch (SB) restenosis.
Aims: Our aim was to identify optical coherence tomographic (OCT) characteristics that may predict SB restenosis (SBR) after UdLMB angioplasty using DKC technique.
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