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June 1, 1999Catheterization and Cardiovascular Interventions

Stent deformation following simulated side-branch dilatation: A comparison of five stent designs

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Key result

Simulated side-branch dilatation with a 4.0-mm balloon caused stent distortion ranging from 36% (Crown) to 65% (NIR), which was abolished by main-lumen redilatation or kissing balloons.

Why the study?

Does main-lumen redilatation or kissing balloons abolish stent distortion caused by side-branch dilatation in various stent designs?

Population

3.5-mm-diameter stents (AVE GFX, beStent, Crown, MultiLink, and NIR) in a plexiglass phantom

Comparison

Simulated side-branch dilatation using 2.5… vs Comparison between different stent designs and…

Design

Preclinical

Authors

JOJohn A. OrmistonUniversity of BergamoMWMark WebsterInterventional CardiologyPRPeter RuygrokInterventional / Structural Cardiology

Discussion

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Implication

Bench simulation suggests side-branch dilatation distorts stent geometry; leaves open optimal redilatation strategies for clinical bifurcation PCI.

Key Points

  • To determine the effects of simulated stent side-branch dilatation and subsequent redilatation of the central lumen.
  • Simulated dilatation through side of various stent designs in a phantom model using multiple balloon sizes.
  • Redilatation of the main lumen performed after side-branch dilatation with various balloon sizes.
  • Inflation of central and side-branch balloons simultaneously (kissing balloons) during experiments.
  • Side-branch dilatation distortion ranged from 36% +/- 2% (Crown) to 65% +/- 6% (NIR) with a 4.0-mm balloon.
  • Main lumen redilatation or kissing balloons eliminated stent stenosis with little reduction of side-lumen diameter.
  • Larger balloon size significantly increased stent distortion immediately distal to the side-branch.

Structured PICO

Does main-lumen redilatation or kissing balloons abolish stent distortion caused by side-branch dilatation in various stent designs?

P
Population
3.5-mm-diameter stents (AVE GFX, beStent, Crown, MultiLink, and NIR) in a plexiglass phantom
I
Intervention
Simulated side-branch dilatation using 2.5-, 3.0-, 3.5-, and 4.0-mm balloons, followed by main lumen redilatation or kissing balloons
C
Comparator
Comparison between different stent designs and balloon sizes
O
Outcome
Stent distortion immediately distal to the side-branchsurrogate

Main stent lumen compromise caused by side-branch dilatation can be effectively corrected by main-lumen redilatation or kissing balloons.

Cite This Study

Ormiston et al. (1999) studied Coronary stent implantation (simulated). Simulated side-branch dilatation and subsequent redilatation vs. Comparison of five stent designs (AVE GFX, beStent, Crown, MultiLink, NIR) was evaluated on Stent distortion immediately distal to the side-branch. Simulated side-branch dilatation with a 4.0-mm balloon caused stent distortion ranging from 36% (Crown) to 65% (NIR), which was abolished by main-lumen redilatation or kissing balloons.

synapsesocial.com/papers/6a6a6ea62ef98b0efacb2667https://doi.org/10.1002/(sici)1522-726x(199906)47:2<258::aid-ccd27>3.0.co;2-c
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Clinical experience with the Palmaz-Schatz coronary stent. Initial results of a multicenter study.1991 · 607 citations
  2. 2A Comparison of Balloon-Expandable-Stent Implantation with Balloon Angioplasty in Patients with Coronary Artery Disease1994 · 4,563 citations
  3. 3Distortion of Palmaz-Schatz stent geometry following side-branch balloon dilation through the stent in a rabbit model1997 · 8 citations
  4. 4A Randomized Comparison of Coronary-Stent Placement and Balloon Angioplasty in the Treatment of Coronary Artery Disease1994 · 4,278 citations
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