Optical Coherence Tomography to Assess Proximal Side Optimization Technique in Crush Stenting
AimThe aim of this study was to explore the potential intraprocedural benefits of the Proximal Side Optimization (PSO) technique by Optical Coherence Tomography (OCT).MethodsA case series of 10 consecutive true bifurcation lesions, with severe long pathology of long side branch (SB), were randomly a...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.861129/full |
| _version_ | 1818140718574600192 |
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| author | Francesco Lavarra Giuseppe Tarantini Davide Sala Vasile Sirbu |
| author_facet | Francesco Lavarra Giuseppe Tarantini Davide Sala Vasile Sirbu |
| author_sort | Francesco Lavarra |
| collection | DOAJ |
| description | AimThe aim of this study was to explore the potential intraprocedural benefits of the Proximal Side Optimization (PSO) technique by Optical Coherence Tomography (OCT).MethodsA case series of 10 consecutive true bifurcation lesions, with severe long pathology of long side branch (SB), were randomly assigned to be treated by standard DK Crush procedure (non-PSO group) as compared to DK Crush in PSO modification (PSO group). The data from OCT investigation before crushing of the SB Drug-Eluting Stent (DES), after crushing, after first kissing balloon inflation (KBI), and after final angiography were compared between the two groups (Public trials registry ISRCTN23355755).ResultsAll 10 cases were successfully treated by the assigned technique. The two groups were similar in terms of indications for the procedure, bifurcation angle, and stent dimensions. As compared to the non-PSO, the PSO group showed larger proximal SB stent areas (5.8 ± 1.8 vs. 4.5 ± 0.5 mm2; p = 0.02), the larger delta between distal and proximal stent areas before crush (1.5 ± 0.7 vs. 0.6 ± 0.5 mm2; p = 0.004), and the larger Space of Optimal Wiring (SOW) after Crush (5.3 ± 1.8 vs. 2.5 ± 1.1 mm2; p = 0.02). The gaps in scaffolding within the ostial segment of the Side Branch DES were found in two patients from the non-PSO group.ConclusionThe DK Crush in PSO modification results in larger SB DES and SOW areas with better apposition to the vessel wall. As result, the SB DES acquires a funnel shape, which reduces the risk of passage outside the SB stent struts during re-wiring, thus, allowing predictable and secure results. |
| first_indexed | 2024-12-11T10:48:26Z |
| format | Article |
| id | doaj.art-8639a8e491f441e09c9de1b66c6bf817 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-11T10:48:26Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-8639a8e491f441e09c9de1b66c6bf8172022-12-22T01:10:25ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-03-01910.3389/fcvm.2022.861129861129Optical Coherence Tomography to Assess Proximal Side Optimization Technique in Crush StentingFrancesco Lavarra0Giuseppe Tarantini1Davide Sala2Vasile Sirbu3Cardiovascular Department, Jilin Heart Hospital, Changchun, ChinaInterventional Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, ItalyCardiovascular Department, Jilin Heart Hospital, Changchun, ChinaCardiovascular Department, Jilin Heart Hospital, Changchun, ChinaAimThe aim of this study was to explore the potential intraprocedural benefits of the Proximal Side Optimization (PSO) technique by Optical Coherence Tomography (OCT).MethodsA case series of 10 consecutive true bifurcation lesions, with severe long pathology of long side branch (SB), were randomly assigned to be treated by standard DK Crush procedure (non-PSO group) as compared to DK Crush in PSO modification (PSO group). The data from OCT investigation before crushing of the SB Drug-Eluting Stent (DES), after crushing, after first kissing balloon inflation (KBI), and after final angiography were compared between the two groups (Public trials registry ISRCTN23355755).ResultsAll 10 cases were successfully treated by the assigned technique. The two groups were similar in terms of indications for the procedure, bifurcation angle, and stent dimensions. As compared to the non-PSO, the PSO group showed larger proximal SB stent areas (5.8 ± 1.8 vs. 4.5 ± 0.5 mm2; p = 0.02), the larger delta between distal and proximal stent areas before crush (1.5 ± 0.7 vs. 0.6 ± 0.5 mm2; p = 0.004), and the larger Space of Optimal Wiring (SOW) after Crush (5.3 ± 1.8 vs. 2.5 ± 1.1 mm2; p = 0.02). The gaps in scaffolding within the ostial segment of the Side Branch DES were found in two patients from the non-PSO group.ConclusionThe DK Crush in PSO modification results in larger SB DES and SOW areas with better apposition to the vessel wall. As result, the SB DES acquires a funnel shape, which reduces the risk of passage outside the SB stent struts during re-wiring, thus, allowing predictable and secure results.https://www.frontiersin.org/articles/10.3389/fcvm.2022.861129/fullbifurcation lesions of coronary arteriesOptical Coherence Tomographypercutaneous coronary interventions (PCI)crush stenting techniquestent optimization |
| spellingShingle | Francesco Lavarra Giuseppe Tarantini Davide Sala Vasile Sirbu Optical Coherence Tomography to Assess Proximal Side Optimization Technique in Crush Stenting Frontiers in Cardiovascular Medicine bifurcation lesions of coronary arteries Optical Coherence Tomography percutaneous coronary interventions (PCI) crush stenting technique stent optimization |
| title | Optical Coherence Tomography to Assess Proximal Side Optimization Technique in Crush Stenting |
| title_full | Optical Coherence Tomography to Assess Proximal Side Optimization Technique in Crush Stenting |
| title_fullStr | Optical Coherence Tomography to Assess Proximal Side Optimization Technique in Crush Stenting |
| title_full_unstemmed | Optical Coherence Tomography to Assess Proximal Side Optimization Technique in Crush Stenting |
| title_short | Optical Coherence Tomography to Assess Proximal Side Optimization Technique in Crush Stenting |
| title_sort | optical coherence tomography to assess proximal side optimization technique in crush stenting |
| topic | bifurcation lesions of coronary arteries Optical Coherence Tomography percutaneous coronary interventions (PCI) crush stenting technique stent optimization |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.861129/full |
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