open access

Vol 23, No 6 (2016)
BASIC SCIENCE AND EXPERIMENTALNTAL CARDIOLOGY - ORIGINAL ARTICLES
Published online: 2016-08-01
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Ex vivo mono-ring technique simplifies culotte stenting for treatment of true bifurcation lesions: Insights from bench testing and clinical application

Lianglong Chen, Lin Fan, Yukun Luo, Wenliang Zhong, Linlin Zhang, Zhaoyang Chen, Chaogui Lin, Yafei Peng, Xingchun Zheng, Xianfeng Dong, Wei Cai
DOI: 10.5603/CJ.a2016.0054
·
Pubmed: 27515483
·
Cardiol J 2016;23(6):673-684.

open access

Vol 23, No 6 (2016)
BASIC SCIENCE AND EXPERIMENTALNTAL CARDIOLOGY - ORIGINAL ARTICLES
Published online: 2016-08-01

Abstract

Background: Despite various culotte-based stenting techniques available clinically, the optimal one remains undetermined. The study aimed to test whether ex vivo mono-ring culotte stenting (MRC) was technically feasible and superior to mini culotte stenting (MCS) in treatment of coronary bifurcation lesions.
Methods: Mono-ring culotte stenting was characterized by ex vivo wiring of the most proximal cell of the side branch (SB) stent to ensure a mono-ring result of the culotte stenting. Comparison of MRC vs. MCS in treatment of true bifurcation lesions was performed in vitro (n = 15 for each group) and in clinical case-controlled study with propensity matching at a ratio of 1:2 (n = 21 for MRC group; n = 42 for MCS group).
Results: Compared to MCS, MRC had lower incidence of stent under-expansion band (0% vs. 53.3%, p = 0.002) and less residual ostial area stenosis of SB (9.2 ± 9.0% vs. 20.0 ± 14.8%, p = 0.023), as assessed in vitro by micro-computed tomography. In a case-controlled study, no adverse cardiac events were observed in the MRC group. The procedural success was similar between MRC and MCS (100% vs. 95.2%, p = 0.548), but MRC had less residual ostial stenosis of the SB (8.7% ± 11.0% vs. 16.8% ± 11.2%, p = 0.008), lower procedural
(33.3 ± 9.5 min vs. 46.7 ± 15.6 min, p = 0.001) and fluoroscopic (19.7 ± 4.9 min vs. 26.2 ± 7.1 min, p < 0.001) time, and less contrast use (114.3 ± 28.9 mL vs. 156.5 ± 56.4 mL, p = 0.002).
Conclusions: Mono-ring culotte stenting as compared to MCS is associated with better bifurcation stent morphology,
less procedural complexity and residual ostial SB stenosis.

Abstract

Background: Despite various culotte-based stenting techniques available clinically, the optimal one remains undetermined. The study aimed to test whether ex vivo mono-ring culotte stenting (MRC) was technically feasible and superior to mini culotte stenting (MCS) in treatment of coronary bifurcation lesions.
Methods: Mono-ring culotte stenting was characterized by ex vivo wiring of the most proximal cell of the side branch (SB) stent to ensure a mono-ring result of the culotte stenting. Comparison of MRC vs. MCS in treatment of true bifurcation lesions was performed in vitro (n = 15 for each group) and in clinical case-controlled study with propensity matching at a ratio of 1:2 (n = 21 for MRC group; n = 42 for MCS group).
Results: Compared to MCS, MRC had lower incidence of stent under-expansion band (0% vs. 53.3%, p = 0.002) and less residual ostial area stenosis of SB (9.2 ± 9.0% vs. 20.0 ± 14.8%, p = 0.023), as assessed in vitro by micro-computed tomography. In a case-controlled study, no adverse cardiac events were observed in the MRC group. The procedural success was similar between MRC and MCS (100% vs. 95.2%, p = 0.548), but MRC had less residual ostial stenosis of the SB (8.7% ± 11.0% vs. 16.8% ± 11.2%, p = 0.008), lower procedural
(33.3 ± 9.5 min vs. 46.7 ± 15.6 min, p = 0.001) and fluoroscopic (19.7 ± 4.9 min vs. 26.2 ± 7.1 min, p < 0.001) time, and less contrast use (114.3 ± 28.9 mL vs. 156.5 ± 56.4 mL, p = 0.002).
Conclusions: Mono-ring culotte stenting as compared to MCS is associated with better bifurcation stent morphology,
less procedural complexity and residual ostial SB stenosis.

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Keywords

coronary bifurcation lesions; percutaneous coronary intervention; culotte stenting

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About this article
Title

Ex vivo mono-ring technique simplifies culotte stenting for treatment of true bifurcation lesions: Insights from bench testing and clinical application

Journal

Cardiology Journal

Issue

Vol 23, No 6 (2016)

Pages

673-684

Published online

2016-08-01

DOI

10.5603/CJ.a2016.0054

Pubmed

27515483

Bibliographic record

Cardiol J 2016;23(6):673-684.

Keywords

coronary bifurcation lesions
percutaneous coronary intervention
culotte stenting

Authors

Lianglong Chen
Lin Fan
Yukun Luo
Wenliang Zhong
Linlin Zhang
Zhaoyang Chen
Chaogui Lin
Yafei Peng
Xingchun Zheng
Xianfeng Dong
Wei Cai

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