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Murasato Y. How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting. Front Cardiovasc Med 2022; 9:1023834. [DOI: 10.3389/fcvm.2022.1023834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022] Open
Abstract
Imaging-guided coronary bifurcation intervention has improved clinical outcomes due to the appropriate size selection of the devices and optimization of the procedure (sufficient stent expansion, reduction of stent malapposition, appropriate stent landing zone, and detection of vessel dissection). In particular, three-dimensional optical coherence tomography (3D OCT) facilitates clear visualization of stent configuration and guidewire position, which promotes optimal guidewire crossing to the side branch. Successive side branch dilation leads to wide ostial dilation with less strut malapposition. However, the link connection of the stent located on the bifurcated carina has been found to be an impediment to sufficient opening of the side branch, resulting in incomplete strut apposition. In such cases, the aggressive proximal optimization technique improves the jailing strut pattern, and 3D OCT navigates the guidewire crossing to the optimal cell that is most likely to be expanded sufficiently, which is not always a distal cell. In two-stent deployment, 3D OCT facilitates optimal guidewire crossing, which leads to less metallic carina, clustering, and overlapping. The present review describes a method of clear visualization and assessment with 3D OCT and discusses the efficacy of 3D OCT in coronary bifurcation stenting in clinical practice.
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Adjedj J, Picard F, Mogi S, Iwasaki K, Aoumeur H, Alansari O, Agudze E, Wijns W, Varenne O. In vitro flow and optical coherence tomography comparison of two bailout techniques after failed provisional stenting for bifurcation percutaneous coronary interventions. Catheter Cardiovasc Interv 2018; 93:E8-E16. [DOI: 10.1002/ccd.27718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/29/2018] [Accepted: 06/10/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Julien Adjedj
- AP-HP, Hôpital Cochin; Paris France
- Faculté de Médecine Paris Descartes, Université Paris Descartes; Paris France
| | - Fabien Picard
- AP-HP, Hôpital Cochin; Paris France
- Faculté de Médecine Paris Descartes, Université Paris Descartes; Paris France
| | - Satoshi Mogi
- AP-HP, Hôpital Cochin; Paris France
- Faculté de Médecine Paris Descartes, Université Paris Descartes; Paris France
| | - Kiyotaka Iwasaki
- Cooperative Major in Advanced Biomedical Sciences; Graduate School of Science and Engineering, Waseda University; Tokyo Japan
| | - Hamid Aoumeur
- AP-HP, Hôpital Cochin; Paris France
- Faculté de Médecine Paris Descartes, Université Paris Descartes; Paris France
| | - Omar Alansari
- AP-HP, Hôpital Cochin; Paris France
- Faculté de Médecine Paris Descartes, Université Paris Descartes; Paris France
| | - Edem Agudze
- AP-HP, Hôpital Cochin; Paris France
- Faculté de Médecine Paris Descartes, Université Paris Descartes; Paris France
| | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland; Galway Ireland
| | - Olivier Varenne
- AP-HP, Hôpital Cochin; Paris France
- Faculté de Médecine Paris Descartes, Université Paris Descartes; Paris France
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