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Kume T, Nishi T, Murasato Y, Koto S, Sasahira Y, Okamoto H, Yamada R, Koyama T, Tamada T, Imai K, Neishi Y, Uemura S. Impact of stent strut link location in proximal balloon edge dilation technique for bifurcation percutaneous coronary intervention. Cardiovasc Interv Ther 2024; 39:137-144. [PMID: 38294663 PMCID: PMC10940397 DOI: 10.1007/s12928-023-00981-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/21/2023] [Indexed: 02/01/2024]
Abstract
The single-stent strategy has generally been accepted as the default approach to bifurcation percutaneous coronary intervention. We have proposed the proximal balloon edge dilation (PBED) technique to prevent stent deformation during side branch (SB) dilation. This bench study aimed to evaluate the impact of stent link location and stent design on stent deformation, obstruction by stent struts at a jailed SB ostium, and incomplete stent apposition in the proximal optimization technique (POT)-PBED procedure. A coronary bifurcation model was used. We intentionally set the absence or presence of stent link on the carina (link-free or link-connect) under videoscope observation and compared stent parameters between 3- and 2-link stents (n = 5 each, n = 20 total). In the link-free group, the SB jailing rate of 3-link stents was significantly higher than that of 2-link stents (15.5 ± 5.1% vs. 6.6 ± 1.2%, p = 0.009). In the link-connect group, the SB jailing rate of 3-link stents was significantly lower than that of 2-link stents (30.0 ± 4.5% vs. 39.0 ± 2.6%, p = 0.009). In the bifurcation segment, the rate of incomplete stent apposition was significantly lower for 3-link stents of the link-connect group than for 2-link stents of the link-connect group (3.3 ± 4.2% vs. 19.0 ± 7.8%, p = 0.009). For both stent designs, ellipticity ratio was higher for link-connect group than link-free group. Link location as well as stent cell design greatly impacted stent deformation during the POT-PBED procedure.
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Affiliation(s)
- Teruyoshi Kume
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan.
| | - Takeshi Nishi
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Yoshinobu Murasato
- Department of Cardiology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Satoshi Koto
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | | | - Hiroshi Okamoto
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Ryotaro Yamada
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Terumasa Koyama
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Tomoko Tamada
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Koichiro Imai
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Yoji Neishi
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
| | - Shiro Uemura
- Department of Cardiology, Kawasaki Medical School, Kurashi, Japan
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Kume T, Nishi T, Murasato Y, Koto S, Yamada R, Koyama T, Tamada T, Imai K, Okamoto H, Neishi Y, Uemura S. Comparative bifurcation bench analysis of three different optimization procedures after main branch stent implantation. Coron Artery Dis 2022; 33:499-501. [PMID: 35212672 DOI: 10.1097/mca.0000000000001136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Teruyoshi Kume
- Department of Cardiology, Kawasaki Medical School, Kurashiki
| | - Takeshi Nishi
- Department of Cardiology, Kawasaki Medical School, Kurashiki
| | - Yoshinobu Murasato
- Department of Cardiology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Satoshi Koto
- Department of Cardiology, Kawasaki Medical School, Kurashiki
| | - Ryotaro Yamada
- Department of Cardiology, Kawasaki Medical School, Kurashiki
| | - Terumasa Koyama
- Department of Cardiology, Kawasaki Medical School, Kurashiki
| | - Tomoko Tamada
- Department of Cardiology, Kawasaki Medical School, Kurashiki
| | - Koichiro Imai
- Department of Cardiology, Kawasaki Medical School, Kurashiki
| | - Hiroshi Okamoto
- Department of Cardiology, Kawasaki Medical School, Kurashiki
| | - Yoji Neishi
- Department of Cardiology, Kawasaki Medical School, Kurashiki
| | - Shiro Uemura
- Department of Cardiology, Kawasaki Medical School, Kurashiki
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