Comparative bifurcation bench analysis of three different optimization procedures after main branch stent implantation
Comparative bifurcation bench analysis of three different optimization procedures after main branch stent implantation
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主分支支架植入后三种不同优化程序的比较分叉台分析
DOI：
10.1097/mca.0000000000001136
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发表时间：
2022
影响因子：
1.8
通讯作者：
Uemura Shiro
中科院分区：
文献类型：
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作者：
Kume Teruyoshi;Nishi Takeshi;Murasato Yoshinobu;Koto Satoshi;Yamada Ryotaro;Koyama Terumasa;Tamada Tomoko;Imai Koichiro;Okamoto Hiroshi;Neishi Yoji;Uemura Shiro
单枚支架或临时侧分支（SB）支架植入术的简单策略已被普遍接受为分叉部经皮冠状动脉介入治疗（PCI）的默认方法[1]。在近端优化技术（POT）手术后，哪种技术是SB扩张治疗的最佳技术仍在讨论中。使用两个长重叠球囊（长KBI）进行对吻球囊充盈（KBI）引起了与支架变形相关的问题[2]。为了最大限度地减少长KBI的缺陷，Murasato等人首先引入了两个接吻气球的短暂重叠。[2]并由Liu等人修改为最小重叠KBI（mini-KBI）。[3]的文件。我们提出了近端球囊边缘扩张（PBED）技术，以防止SB扩张过程中支架变形，并使用POT-PBED手术在分叉病变中交叉植入单支架获得了极好的结果[4]。因此，本实验室研究旨在评价MB支架植入术后三种不同SB开口治疗的结果，包括长KBI、小KBI和PBED技术。由柔性聚氨酯（厚度，1 mm）制成的分形冠状动脉分叉实验室模型专门设计为主分支的管腔直径为3.5 mm，SB的管腔直径为3.0 mm，隆突角为70（Cross Medical Service Co.，日本东京）。比较了MB支架植入术后的三种不同SB开口治疗（n= 15，Xience Sierra; Abbott Vascular，Santa Clara，CA，USA），包括长KBI组、微型KBI组和PBED组。首先，在额定爆破压（18 atm）下将3.5 mm支架植入MB中，共植入3次，每次10 s。为了避免连接位置的影响，我们有意在视频内窥镜观察下将SB口远端的支架连接设置为缺失（IPLEX TX; Olympus，Tokyo，Japan）。二是
Simple strategies with a single stent or provisional side branch (SB) stenting have generally been accepted as the default approach for bifurcation percutaneous coronary intervention (PCI)[1]. After the proximal optimization technique (POT) procedure, which technique is optimal for SB dilation treatments remains under discussion. Kissing balloon inflation (KBI) using two balloons with a long overlap (long-KBI) has caused concerns related to stent deformation [2]. To minimize the defects of long-KBI, short overlap of the two kissing balloons was first introduced by Murasato et al.[2] and modified as minimally overlapping KBI (mini-KBI) by Liu et al.[3]. We proposed the proximal balloon edge dilation (PBED) technique to prevent stent deformation during SB dilation and achieved excellent results from cross-over single-stent implantation in bifurcation lesions using POT-PBED procedures [4]. This bench study therefore aimed to evaluate the results of three different SB ostial treatments after MB stenting, including long-KBI, mini-KBI, and PBED techniques.A fractal coronary bifurcation bench model made of flexible urethane (thickness, 1 mm) was specially designed with lumen diameters of 3.5 mm for the main branch and 3.0 mm for the SB, with carina angles of 70 (Cross Medical Service Co., Tokyo, Japan). Three different SB ostial treatments after MB stenting (n= 15, Xience Sierra; Abbott Vascular, Santa Clara, CA, USA), comprising a long-KBI group, mini-KBI group, and PBED group, were compared. First, 3.5-mm stents in the MB were implanted at the rated burst pressure (18 atm) three times for 10 s each time. To avoid the influence of link location, we intentionally set the absence of stent link at the distal semicircle of the SB ostium under videoscope observation (IPLEX TX; Olympus, Tokyo, Japan). Second, a