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Intravascular ultrasound comparison of the self‐expanding sideguard stent in the side branch versus a balloon‐expandable stent in the main vessel to assess mechanisms of acute lumen gain in bifurcation lesions

Identifieur interne : 000A28 ( Istex/Corpus ); précédent : 000A27; suivant : 000A29

Intravascular ultrasound comparison of the self‐expanding sideguard stent in the side branch versus a balloon‐expandable stent in the main vessel to assess mechanisms of acute lumen gain in bifurcation lesions

Auteurs : Shixin Ma ; Akiko Maehara ; Karl E. Hauptmann ; Giulio Guagliumi ; Orazio Valsecchi ; Angelina Vassileva ; Yolande Appelman ; Giuseppe Sangiorgi ; Francesco Prati ; Gary S. Mintz

Source :

RBID : ISTEX:72C2B4198823D0DFADAFD1C71D5DADF0682EB24F

Abstract

We compared the mechanisms of lumen gain after Cappella Sideguard (CS) side branch (SB) bifurcation stent deployment versus a balloon‐expandable stent in the corresponding main vessel (MV).

Url:
DOI: 10.1002/ccd.24953

Links to Exploration step

ISTEX:72C2B4198823D0DFADAFD1C71D5DADF0682EB24F

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<p>We compared the mechanisms of lumen gain after Cappella Sideguard (CS) side branch (SB) bifurcation stent deployment versus a balloon‐expandable stent in the corresponding main vessel (MV).</p>
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<p>The novel CS SB bifurcation stent is a self‐expanding, thin‐strut, nitinol device with anatomic flaring at the SB ostium.</p>
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<p>In 28 bifurcation lesions, intravascular ultrasound imaging of both the SB and the MV was performed both pre‐ and postintervention; vessel and lumen areas were measured every 1 mm over a 5 mm segment beginning at the carina.</p>
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<p>Although minimum lumen area (MLA) within the distal 5 mm segment beginning at the carina increased from 2.8 ± 1.3 mm2 to 3.8 ± 1.1 mm2, P < 0.001, in the SB and from 3.4 ± 1.4 mm2 to 6.0 ± 1.1 mm2, P < 0.001, in the MV, stent expansion (minimum stent area/distal reference lumen area) was significantly less in the SB compared with the MV (77.8 ± 21.3% vs. 91.6 ± 18.4%, P = 0.02). Post stenting, the MLA site was located at the carina more frequently in the SB (85.7%) than in the MV (60.7%), P = 0.04. Plaque volume in the 5 mm proximal to carina in the MV tended to decrease, whereas plaque volume in the SB increased slightly with no change in overall plaque volume in the 5‐mm‐long segment distal to the carina in the MV, suggesting plaque shift from the proximal MV to the SB.</p>
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<p>Acute CS lumen gain is less than the lumen gain of a balloon‐expandable stent in the MV because of less aggressive acute expansion and/or the plaque shift from the proximal MV to the SB. © 2013 Wiley Periodicals, Inc.</p>
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<correspondenceTo>Correspondence to: Akiko Maehara, Cardiovascular Research Foundation, 111 East 59th Street, 12th Floor, New York, NY 10022. E‐mail:
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<creator affiliationRef="#ccd24953-aff-0001 #ccd24953-aff-0002" creatorRole="author" xml:id="ccd24953-cr-0001">
<personName>
<givenNames>Shixin</givenNames>
<familyName>Ma</familyName>
<degrees>MD</degrees>
</personName>
</creator>
<creator affiliationRef="#ccd24953-aff-0001 #ccd24953-aff-0002" corresponding="yes" creatorRole="author" xml:id="ccd24953-cr-0002">
<personName>
<givenNames>Akiko</givenNames>
<familyName>Maehara</familyName>
<degrees>MD</degrees>
</personName>
</creator>
<creator affiliationRef="#ccd24953-aff-0003" creatorRole="author" xml:id="ccd24953-cr-0003">
<personName>
<givenNames>Karl E.</givenNames>
<familyName>Hauptmann</familyName>
<degrees>MD</degrees>
</personName>
</creator>
<creator affiliationRef="#ccd24953-aff-0004" creatorRole="author" xml:id="ccd24953-cr-0004">
<personName>
<givenNames>Giulio</givenNames>
<familyName>Guagliumi</familyName>
<degrees>MD</degrees>
</personName>
</creator>
<creator affiliationRef="#ccd24953-aff-0004" creatorRole="author" xml:id="ccd24953-cr-0005">
<personName>
<givenNames>Orazio</givenNames>
<familyName>Valsecchi</familyName>
<degrees>MD</degrees>
</personName>
</creator>
<creator affiliationRef="#ccd24953-aff-0004" creatorRole="author" xml:id="ccd24953-cr-0006">
<personName>
<givenNames>Angelina</givenNames>
<familyName>Vassileva</familyName>
<degrees>MD</degrees>
</personName>
</creator>
<creator affiliationRef="#ccd24953-aff-0005" creatorRole="author" xml:id="ccd24953-cr-0007">
<personName>
<givenNames>Yolande</givenNames>
<familyName>Appelman</familyName>
<degrees>MD</degrees>
</personName>
</creator>
<creator affiliationRef="#ccd24953-aff-0006" creatorRole="author" xml:id="ccd24953-cr-0008">
<personName>
<givenNames>Giuseppe</givenNames>
<familyName>Sangiorgi</familyName>
<degrees>MD</degrees>
</personName>
</creator>
<creator affiliationRef="#ccd24953-aff-0007" creatorRole="author" xml:id="ccd24953-cr-0009">
<personName>
<givenNames>Francesco</givenNames>
<familyName>Prati</familyName>
<degrees>MD</degrees>
</personName>
</creator>
<creator affiliationRef="#ccd24953-aff-0001" creatorRole="author" xml:id="ccd24953-cr-0010">
<personName>
<givenNames>Gary S.</givenNames>
<familyName>Mintz</familyName>
<degrees>MD</degrees>
</personName>
</creator>
</creators>
<affiliationGroup>
<affiliation countryCode="US" type="organization" xml:id="ccd24953-aff-0001">
<orgName>Cardiovascular Research Foundation</orgName>
<address>
<city>New York</city>
<countryPart>NY</countryPart>
</address>
</affiliation>
<affiliation countryCode="US" type="organization" xml:id="ccd24953-aff-0002">
<orgName>Columbia University Medical Center</orgName>
<address>
<city>New York</city>
<countryPart>NY</countryPart>
</address>
</affiliation>
<affiliation countryCode="DE" type="organization" xml:id="ccd24953-aff-0003">
<orgName>Krankenhaus der Barmherzigen Brüder</orgName>
<address>
<city>Trier</city>
<country>Germany</country>
</address>
</affiliation>
<affiliation countryCode="IT" type="organization" xml:id="ccd24953-aff-0004">
<orgName>Ospedale Papa Giovanni XXIII</orgName>
<address>
<city>Bergamo</city>
<country>Italy</country>
</address>
</affiliation>
<affiliation type="organization" xml:id="ccd24953-aff-0005">
<orgName>VU University Medical Center</orgName>
<address>
<city>Amsterdam</city>
<country>The Netherlands</country>
</address>
</affiliation>
<affiliation countryCode="IT" type="organization" xml:id="ccd24953-aff-0006">
<orgName>Policlinico Casilino</orgName>
<address>
<city>Rome</city>
<country>Italy</country>
</address>
</affiliation>
<affiliation countryCode="IT" type="organization" xml:id="ccd24953-aff-0007">
<orgName>San Giovanni Hospital</orgName>
<address>
<city>Rome</city>
<country>Italy</country>
</address>
</affiliation>
</affiliationGroup>
<keywordGroup type="author">
<keyword xml:id="ccd24953-kwd-0001">self‐expanding stent</keyword>
<keyword xml:id="ccd24953-kwd-0002">bifurcation lesion</keyword>
<keyword xml:id="ccd24953-kwd-0003">intravascular ultrasound</keyword>
<keyword xml:id="ccd24953-kwd-0004">lumen gain</keyword>
</keywordGroup>
<abstractGroup>
<abstract type="main">
<section xml:id="ccd24953-sec-0001">
<title type="main">Objectives</title>
<p>We compared the mechanisms of lumen gain after Cappella Sideguard (CS) side branch (SB) bifurcation stent deployment versus a balloon‐expandable stent in the corresponding main vessel (MV).</p>
</section>
<section xml:id="ccd24953-sec-0002">
<title type="main">Background</title>
<p>The novel CS SB bifurcation stent is a self‐expanding, thin‐strut, nitinol device with anatomic flaring at the SB ostium.</p>
</section>
<section xml:id="ccd24953-sec-0003">
<title type="main">Methods</title>
<p>In 28 bifurcation lesions, intravascular ultrasound imaging of both the SB and the MV was performed both pre‐ and postintervention; vessel and lumen areas were measured every 1 mm over a 5 mm segment beginning at the carina.</p>
</section>
<section xml:id="ccd24953-sec-0004">
<title type="main">Results</title>
<p>Although minimum lumen area (MLA) within the distal 5 mm segment beginning at the carina increased from 2.8 ± 1.3 mm
<sup>2</sup>
to 3.8 ± 1.1 mm
<sup>2</sup>
,
<i>P</i>
 < 0.001, in the SB and from 3.4 ± 1.4 mm
<sup>2</sup>
to 6.0 ± 1.1 mm
<sup>2</sup>
,
<i>P</i>
 < 0.001, in the MV, stent expansion (minimum stent area/distal reference lumen area) was significantly less in the SB compared with the MV (77.8 ± 21.3% vs. 91.6 ± 18.4%,
<i>P</i>
 = 0.02). Post stenting, the MLA site was located at the carina more frequently in the SB (85.7%) than in the MV (60.7%),
<i>P</i>
 = 0.04. Plaque volume in the 5 mm proximal to carina in the MV tended to decrease, whereas plaque volume in the SB increased slightly with no change in overall plaque volume in the 5‐mm‐long segment distal to the carina in the MV, suggesting plaque shift from the proximal MV to the SB.</p>
</section>
<section xml:id="ccd24953-sec-0005">
<title type="main">Conclusions</title>
<p>Acute CS lumen gain is less than the lumen gain of a balloon‐expandable stent in the MV because of less aggressive acute expansion and/or the plaque shift from the proximal MV to the SB. © 2013 Wiley Periodicals, Inc.</p>
</section>
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<title>Intravascular ultrasound comparison of the self‐expanding sideguard stent in the side branch versus a balloon‐expandable stent in the main vessel to assess mechanisms of acute lumen gain in bifurcation lesions</title>
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<titleInfo type="abbreviated" lang="en">
<title>Mechanisms of Lumen Gain in Bifurcation Lesions</title>
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<title>Intravascular ultrasound comparison of the self‐expanding sideguard stent in the side branch versus a balloon‐expandable stent in the main vessel to assess mechanisms of acute lumen gain in bifurcation lesions</title>
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<name type="personal">
<namePart type="given">Shixin</namePart>
<namePart type="family">Ma</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Cardiovascular Research Foundation, New York, NY</affiliation>
<affiliation>Columbia University Medical Center, NY, New York</affiliation>
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<name type="personal">
<namePart type="given">Akiko</namePart>
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<namePart type="termsOfAddress">MD</namePart>
<affiliation>Cardiovascular Research Foundation, New York, NY</affiliation>
<affiliation>Columbia University Medical Center, NY, New York</affiliation>
<affiliation>E-mail: amaehara@crf.org</affiliation>
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<affiliation>Krankenhaus der Barmherzigen Brüder, Trier, Germany</affiliation>
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<name type="personal">
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<namePart type="family">Guagliumi</namePart>
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<affiliation>Ospedale Papa Giovanni XXIII, Bergamo, Italy</affiliation>
<role>
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</name>
<name type="personal">
<namePart type="given">Orazio</namePart>
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<namePart type="termsOfAddress">MD</namePart>
<affiliation>Ospedale Papa Giovanni XXIII, Bergamo, Italy</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
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</name>
<name type="personal">
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<affiliation>Ospedale Papa Giovanni XXIII, Bergamo, Italy</affiliation>
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</name>
<name type="personal">
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<namePart type="termsOfAddress">MD</namePart>
<affiliation>VU University Medical Center, Amsterdam, The Netherlands</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Giuseppe</namePart>
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<namePart type="termsOfAddress">MD</namePart>
<affiliation>Policlinico Casilino, Rome, Italy</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Francesco</namePart>
<namePart type="family">Prati</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>San Giovanni Hospital, Rome, Italy</affiliation>
<role>
<roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal">
<namePart type="given">Gary S.</namePart>
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<affiliation>Cardiovascular Research Foundation, NY, New York</affiliation>
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<dateIssued encoding="w3cdtf">2013-11-01</dateIssued>
<dateCreated encoding="w3cdtf">2013-04-29</dateCreated>
<dateCaptured encoding="w3cdtf">2012-12-01</dateCaptured>
<dateValid encoding="w3cdtf">2013-04-09</dateValid>
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<abstract>We compared the mechanisms of lumen gain after Cappella Sideguard (CS) side branch (SB) bifurcation stent deployment versus a balloon‐expandable stent in the corresponding main vessel (MV).</abstract>
<abstract>The novel CS SB bifurcation stent is a self‐expanding, thin‐strut, nitinol device with anatomic flaring at the SB ostium.</abstract>
<abstract>In 28 bifurcation lesions, intravascular ultrasound imaging of both the SB and the MV was performed both pre‐ and postintervention; vessel and lumen areas were measured every 1 mm over a 5 mm segment beginning at the carina.</abstract>
<abstract>Although minimum lumen area (MLA) within the distal 5 mm segment beginning at the carina increased from 2.8 ± 1.3 mm2 to 3.8 ± 1.1 mm2, P < 0.001, in the SB and from 3.4 ± 1.4 mm2 to 6.0 ± 1.1 mm2, P < 0.001, in the MV, stent expansion (minimum stent area/distal reference lumen area) was significantly less in the SB compared with the MV (77.8 ± 21.3% vs. 91.6 ± 18.4%, P = 0.02). Post stenting, the MLA site was located at the carina more frequently in the SB (85.7%) than in the MV (60.7%), P = 0.04. Plaque volume in the 5 mm proximal to carina in the MV tended to decrease, whereas plaque volume in the SB increased slightly with no change in overall plaque volume in the 5‐mm‐long segment distal to the carina in the MV, suggesting plaque shift from the proximal MV to the SB.</abstract>
<abstract>Acute CS lumen gain is less than the lumen gain of a balloon‐expandable stent in the MV because of less aggressive acute expansion and/or the plaque shift from the proximal MV to the SB. © 2013 Wiley Periodicals, Inc.</abstract>
<subject>
<genre>keywords</genre>
<topic>self‐expanding stent</topic>
<topic>bifurcation lesion</topic>
<topic>intravascular ultrasound</topic>
<topic>lumen gain</topic>
</subject>
<relatedItem type="host">
<titleInfo>
<title>Catheterization and Cardiovascular Interventions</title>
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<title>Cathet. Cardiovasc. Intervent.</title>
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<genre type="journal">journal</genre>
<subject>
<genre>article-category</genre>
<topic>Coronary Artery Disease</topic>
</subject>
<identifier type="ISSN">1522-1946</identifier>
<identifier type="eISSN">1522-726X</identifier>
<identifier type="DOI">10.1002/(ISSN)1522-726X</identifier>
<identifier type="PublisherID">CCD</identifier>
<part>
<date>2013</date>
<detail type="volume">
<caption>vol.</caption>
<number>82</number>
</detail>
<detail type="issue">
<caption>no.</caption>
<number>5</number>
</detail>
<extent unit="pages">
<start>748</start>
<end>754</end>
<total>7</total>
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</part>
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<accessCondition type="use and reproduction" contentType="copyright">Copyright © 2013 Wiley Periodicals, Inc.Copyright © 2013 Wiley Periodicals, Inc.</accessCondition>
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