T and Small Protrusion (TAP) vs Double-Kissing Crush Technique: Insights From In Vitro Models

نویسندگان

چکیده

Abstract Background Percutaneous coronary interventions on complex bifurcation lesions may require implantation of two stents to appropriately treat diffuse side-branch (SB) disease. Comparisons among different stenting techniques are continuously attempted by various study designs (bench tests, computer simulations, clinical studies). Among techniques, double kissing crush (DKC) represents the last evolution for “crushing” while T and small Protrusion (TAP) “T stenting”. Both actually gaining popularity, but head-to-head comparisons lacking. Methods results Two generation drug-eluting (Synergy™, Boston Scientific, MA, USA Ultimaster™,Terumo Corp., Japan) were implanted in left main bench models using TAP (n = 6 sets) DKC techniques. A peristaltic pump with fresh porcine blood was used perfuse through silicone model at a flow rate 200 ml/min 4 min. Optical coherence tomography (OCT) assess stent struts geometry thrombus formation . SB cross sectional area as well obstruction did not significantly differ between Numerical (but statistically significant) differences found terms malapposed (fewer TAP) floating DKC). Thrombus after perfusion similar technique (1.53 ± 1.12 vs. 1.20 ± 1.01 mm 2, p = 0.6). Conclusion The result present in-vitro shows absence significant difference apposition acute potential. Despite completely technical steps required, both have performance according such articulated pre-clinical evaluation. What is already known about this subject? Due its limited complexity, considered to-go good long-term results. Recently, has been popularity demonstrated promising randomized trials. does add? This test provides unique detailed OCT comparison local hemodynamic environment analysis How might impact practice? New insights thrombogenicity computational simulation guide percutaneous therapeutic strategies lesions.

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ژورنال

عنوان ژورنال: Cardiovascular Revascularization Medicine

سال: 2021

ISSN: ['1878-0938', '1553-8389']

DOI: https://doi.org/10.1016/j.carrev.2020.09.013