Serial intravascular ultrasound analysis of complex bifurcation coronary lesions treated with the tryton bifurcation stent in conjunction with an everolimus-eluting stent : IUVANT (Intravascular Ultrasound Evaluation of Tryton Stent) study
Articolo
Data di Pubblicazione:
2015
Citazione:
Serial intravascular ultrasound analysis of complex bifurcation coronary lesions treated with the tryton bifurcation stent in conjunction with an everolimus-eluting stent : IUVANT (Intravascular Ultrasound Evaluation of Tryton Stent) study / A.L. Bartorelli, D. Trabattoni, A. Almonacid, F. Fabbiocchi, P. Montorsi, S. Galli, L. Grancini, P. Ravagnani, G.S. Mintz, A.V. Kaplan, J.J. Popma, A. Maehara. - In: CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS. - ISSN 1522-1946. - 85:4(2015), pp. 544-553. [10.1002/ccd.25629]
Abstract:
Objectives: To characterize the treatment of complex bifurcation lesions (BL) with the Tryton Bifurcation Stent (TBS) paired with an everolimus-eluting stent (EES). Background: Complex BL are associated with higher procedural complications and poorer long-term outcomes. The TBS is a dedicated side-branch (SB) stent designed to be used in conjunction with a standard drug-eluting stent. Methods: Prospectively identified, consecutive patients underwent TBS1EES stenting of BL using a protocol which included TBS postdilation and simultaneous final kissing balloon inflations (FKBI). All lesions were systematically evaluated with coronary angiography and IVUS, obtained at procedure completion and at 9 months, and were assessed by independent core laboratories. Results: Thirty-three BL were treated in 32 patients presenting primarily (87.5%) with stable angina and complex BL with angiographic apparent disease in the main vessel (MV) and SB in 87.9% and 75% by site and core evaluation, respectively. Procedural success was 100% and high postprocedure percent stent expansion (MV 96 [93, 109]%, SB 88 [77, 100]%, carina MV 135 [99, 166]%, carina SB 116 [91, 130]%) was demonstrated by IVUS. At 9-month angiographic follow-up (n = 28 patients), one MV in-segment restenosis and one SB in-stent restenosis were observed. SB in-stent late lumen loss was 0.41 ± 0.27 mm. IVUS assessment revealed the absence of stent recoil; percent carinal neointimal hyperplasia (NIH) was 1.8 [0.0,11.2]% in MV and 15.0 [6.7,23.5]% in SB, with NIH volume obstruction of 2.0 [0.7,4.3]% in MV and 14.2 [7.5,29.6]% in SB. Conclusions: Stenting of complex BL with the TBS+EES provides high acute success with sustained clinical, angiographic, and IVUS results at 9 months. These excellent results are likely due to the extent of stent expansion at the carina.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Bifurcation lesions; Coronary stenting; Dedicated bifurcation stents; Intravascular ultrasound; Percutaneous coronary intervention; Aged; Cardiovascular Agents; Coronary Angiography; Coronary Artery Disease; Coronary Vessels; Everolimus; Female; Humans; Male; Middle Aged; Percutaneous Coronary Intervention; Predictive Value of Tests; Prospective Studies; Prosthesis Design; Time Factors; Treatment Outcome; Drug-Eluting Stents; Ultrasonography, Interventional; Radiology, Nuclear Medicine and Imaging; Cardiology and Cardiovascular Medicine
Elenco autori:
A.L. Bartorelli, D. Trabattoni, A. Almonacid, F. Fabbiocchi, P. Montorsi, S. Galli, L. Grancini, P. Ravagnani, G.S. Mintz, A.V. Kaplan, J.J. Popma, A. Maehara
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