Optical coherence tomography assessment of a new dedicated bifurcation stent.
OBJECTIVE
Dedicated bifurcation stents should facilitate deployment and improve coverage of bifurcational lesions. We used optical coherence tomography (OCT) to assess bifurcation lesions treated with a dedicated stent implanted in the side branch (SB) in conjunction with drug eluting stents in the main vessel (MV) in a culotte-like fashion.


RESULTS
Nine patients treated with the Tryton stent underwent postprocedural OCT examination. Total percent of malapposed struts per patient was 18.1+/-8.7%. The longitudinal distribution of the percent of malapposed struts per patient showed that the prevalence of malapposed struts was significantly higher at the level of the bifurcation (33.3%), than in both the proximal segment and the distal segment (18.5% and 9.8%, respectively, p=0.011). When the bifurcation was divided into two halves (opposite SB and toward SB), the highest percent of malapposed struts was toward the SB (47.6%). Also the wall-strut distance for malapposed struts was significantly higher in the bifurcation half toward the SB than in the proximal and the distal segment.


CONCLUSIONS
Malapposed struts are frequent in bifurcations despite the use of a dedicated stent. The highest frequency and largest vessel wall-stent strut distance are observed in the bifurcation half toward the SB.
Royal Brompton Hospital, London, United Kingdom.
Pawel
P
Tyczynski
Giuseppe
G
Ferrante
Neville
N
Kukreja
Cristina
C
Moreno-Ambroj
Peter
P
Barlis
Nandakumar
N
Ramasami
Ranil
R
De Silva
Kevin
K
Beatt
Carlo
C
Di Mario
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D019210:Troponin I