Resorbable Magnesium Scaffold in Coronary Bifurcations - Report of in Vitro Experiments.
Coronary bifurcation
In vitro
Resorbable magnesium scaffold
Journal
Cardiovascular revascularization medicine : including molecular interventions
ISSN: 1878-0938
Titre abrégé: Cardiovasc Revasc Med
Pays: United States
ID NLM: 101238551
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
29
10
2018
revised:
27
11
2018
accepted:
27
11
2018
pubmed:
7
1
2019
medline:
23
6
2020
entrez:
7
1
2019
Statut:
ppublish
Résumé
The aim of this work is to evaluate in an in vitro setting the behavior of resorbable magnesium scaffolds (RMS) in bifurcations. As coronary bifurcations represent an important portion of all PCIs, it is crucial to understand whether RMS is applicable in these complex lesions. Performance of RMS was evaluated with focus on bifurcations. In bifurcations RMS was tested for (1) main branch stenting with side branch opening and proximal optimization; for (2) main branch stenting with final kissing and proximal optimization; for (3) T-and-protrusion technique; for (4) string technique, which is a minimalistic version of conventional culotte technique. All tests were performed using 3.50 × 25 mm RMS. Results were evaluated by fluoroscopy, optical coherence tomography (OCT) and micro-computed tomography (μCT), for scaffold conformability, strut apposition, structural deformation and strut fracture. All planned procedural steps were performed successfully with good result according to fluoroscopy. By OCT the overall malapposition rate in bifurcation cases was 4.3%, occurring predominantly in the carinal area. No malapposition was seen at the proximal main branch confirming proper conformability of RMS. μCT analysis has shown that final kissing dilation resulted in fully stretched struts in cases, where performed with 3.5 and 3.0 mm balloons. In one case a broken connector (T-and-protrusion) and in another case, a broken strut (String technique) were identified. RMS can structurally cope with bifurcations. Still, for cases and techniques where overexpansion beyond the recommended limit is needed, RMS might not be the proper device due to risk of strut fracture.
Sections du résumé
OBJECTIVES
The aim of this work is to evaluate in an in vitro setting the behavior of resorbable magnesium scaffolds (RMS) in bifurcations.
BACKGROUND
As coronary bifurcations represent an important portion of all PCIs, it is crucial to understand whether RMS is applicable in these complex lesions.
METHODS
Performance of RMS was evaluated with focus on bifurcations. In bifurcations RMS was tested for (1) main branch stenting with side branch opening and proximal optimization; for (2) main branch stenting with final kissing and proximal optimization; for (3) T-and-protrusion technique; for (4) string technique, which is a minimalistic version of conventional culotte technique. All tests were performed using 3.50 × 25 mm RMS. Results were evaluated by fluoroscopy, optical coherence tomography (OCT) and micro-computed tomography (μCT), for scaffold conformability, strut apposition, structural deformation and strut fracture.
RESULTS
All planned procedural steps were performed successfully with good result according to fluoroscopy. By OCT the overall malapposition rate in bifurcation cases was 4.3%, occurring predominantly in the carinal area. No malapposition was seen at the proximal main branch confirming proper conformability of RMS. μCT analysis has shown that final kissing dilation resulted in fully stretched struts in cases, where performed with 3.5 and 3.0 mm balloons. In one case a broken connector (T-and-protrusion) and in another case, a broken strut (String technique) were identified.
CONCLUSIONS
RMS can structurally cope with bifurcations. Still, for cases and techniques where overexpansion beyond the recommended limit is needed, RMS might not be the proper device due to risk of strut fracture.
Identifiants
pubmed: 30611652
pii: S1553-8389(18)30568-2
doi: 10.1016/j.carrev.2018.11.023
pii:
doi:
Substances chimiques
Magnesium
I38ZP9992A
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
858-864Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2018. Published by Elsevier Inc.