Drug-Eluting Stents in Bifurcations Bench Study of Strut Deformation and Coating Lesions
Drug-Eluting Stents in Bifurcations Bench Study of Strut Deformation and Coating Lesions
复制标题
DOI：
10.1161/circinterventions.108.846089
复制
发表时间：
2010-04-01
影响因子：
5.6
通讯作者：
Loirand, Gervaise
中科院分区：
文献类型：
--
作者：
Guerin, Patrice;Pilet, Paul;Loirand, Gervaise
背景：药物洗脱支架（DES）的使用极大地限制了分叉病变支架内再狭窄的发生率；然而，再狭窄仍然是分叉侧支起源处的一个问题。本研究的目的是利用微聚焦x射线计算机断层扫描和扫描电子显微镜分析接吻后扩张技术对5例DESs的影响。方法与结果：5种不同的DESs （Cypher, Cypher Select, Endeavor， Taxus Express和Taxus Liberte）采用接吻后扩张方案在台台模型中部署。对于所有类型的DES，微焦x线计算机断层扫描分析显示：(1)用2个同轴球囊吻合支架后扩张引起近段椭圆形变形；(2)吻合后扩张技术降低了潜在金属与动脉的比值(制造商数据/计算比值[%]:Cypher， 12.7/8.8; Cypher Select, 13.5/10.2; Endeavor, 19.0/13.3; Taxus Express, 20.5/4.7；自由红豆杉（Taxus Liberte）， 17.9/12.5)和近段区域的潜在药物应用，包括口支（侧分支口附近和周围的支）(制造商数据/计算药物应用[mu g/mm(2)]: Cypher, 1.4/1.0；Cypher Select, 1.4/1.1；努力,1.6/1.1;Taxus Express 1.0/0.7；自由红豆杉，1.0/0.7)。扫描电镜分析显示，在所有评估的支架中，涂层对口支的损伤明显更大(P
Background-The use of a drug-eluting stent (DES) has strongly limited the incidence of in-stent restenosis in bifurcation lesions; nevertheless, restenosis still remains a problem at the origin of the bifurcation side branch. The aim of this study is to analyze the consequences of the kissing postdilatation technique on 5 DESs, using microfocus x-ray computerized tomography and scanning electron microscopy.Methods and Results-Five different DESs (Cypher, Cypher Select, Endeavor, Taxus Express, and Taxus Liberte) were deployed using kissing postdilatation protocols in a bench-top model. For all types of DES, microfocus x-ray computerized tomography analysis showed that (1) kissing postdilatation of the stent by 2 coaxial balloons caused elliptic deformation in the proximal segment and (2) kissing postdilatation technique reduced the ratio of potential metal to artery (manufacturer's data/calculated ratio [%]: Cypher, 12.7/8.8; Cypher Select, 13.5/10.2; Endeavor, 19.0/13.3; Taxus Express, 20.5/4.7; Taxus Liberte, 17.9/12.5) and the potential drug application to area in the proximal segment, including the ostial struts (struts adjacent to and lying around the side branch ostium) (manufacturer's data/calculated drug application [mu g/mm(2)]: Cypher, 1.4/1.0; Cypher Select, 1.4/1.1; Endeavor, 1.6/1.1; Taxus Express, 1.0/0.7; Taxus Liberte, 1.0/0.7). Scanning electron microscopy analysis showed a significantly greater coating damage to the ostial struts in all stents evaluated (P