Ikeno Fumiaki, Kim Young-Hak, Luna Jorge, Condado Jose A, Colombo Antonio, Grube Eberhard, Fitzgerald Peter J, Park Seung-Jung, Yeung Alan C
Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94304, USA.
Catheter Cardiovasc Interv. 2006 Feb;67(2):198-206. doi: 10.1002/ccd.20556.
To evaluate technical feasibility and procedural safety of SLK-View stent for treating bifurcation lesions.
Percutaneous treatment of coronary bifurcation lesions represents a technical challenge. Several stenting techniques and dedicated devices have proven unsuccessful, with high rates of side branch occlusion at index procedure and follow-up.
Eighty one patients with 84 de novo coronary artery lesions involving a major side branch underwent SLK-View (Advanced Stent Technologies, Inc., Pleasanton, CA) stent implantation with subsequent kissing balloon post dilatation. SLK-View stent is a new scaffolding device incorporating a side aperture that allows access to the side-branch of a bifurcation after deployment of the stent in main vessel. All patients underwent angiographic follow-up at 6 months. Procedural, in-hospital, and 6-month follow-up outcomes were examined.
The lesions were located in left main (n = 11), left anterior descending (n = 50), left circumflex (n = 8), right coronary artery (n = 7), and 1 ramus intermedius. The most frequent lesions (44.1%) were true bifurcations. Successful stent delivery to bifurcation was accomplished in 82/84 of the cases (97.6%). Technical success was obtained in 99 and 94% of main vessel and side branches, respectively. Stenting in side-branch was performed in 21 lesions (25%). Side-branches were accessed effectively in 100% of bifurcations postprocedurally. Binary restenosis rate at 6-month follow-up was 28.3% and 37.7% for main vessel and side-branch, respectively. TLR rate at 6-month follow-up was 21% and CABG rate of 6%.
In this consecutive multicenter series of patients with coronary bifurcation lesions, this novel side-branch access stent proved feasible, with a high procedural success rate, while maintaining side-branch access.
评估SLK-View支架治疗分叉病变的技术可行性和操作安全性。
经皮冠状动脉分叉病变的治疗是一项技术挑战。多种支架置入技术和专用器械已被证明并不成功，在初次手术及随访时侧支闭塞率较高。
81例患有84处累及主要侧支的冠状动脉初发病变的患者接受了SLK-View（先进支架技术公司，加利福尼亚州普莱森顿）支架植入，随后进行球囊后扩张。SLK-View支架是一种新型支架装置，带有侧孔，在主血管置入支架后可进入分叉病变的侧支。所有患者在6个月时接受血管造影随访。检查手术、住院期间及6个月随访结果。
病变位于左主干（n = 11）、左前降支（n = 50）、左旋支（n = 8）、右冠状动脉（n = 7）及1支中间支。最常见的病变（44.1%）为真性分叉病变。84例中有82例（97.6%）成功将支架置入分叉病变处。主血管和侧支的技术成功率分别为99%和94%。21处病变（25%）进行了侧支支架置入。术后100%的分叉病变侧支均能有效开通。6个月随访时主血管和侧支的二元再狭窄率分别为28.3%和37.7%。6个月随访时靶病变血运重建率为21%，冠状动脉旁路移植术率为6%。
在这一连续性多中心冠状动脉分叉病变患者系列中，这种新型侧支开通支架被证明是可行的，手术成功率高，同时能保持侧支开通。
