Ikeno Fumiaki, Buchbinder Maurice, Yeung Alan C
Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA 94304, USA.
Cardiovasc Revasc Med. 2007 Jan-Mar;8(1):38-42. doi: 10.1016/j.carrev.2006.10.003.
In percutaneous treatment of bifurcation coronary lesions, side-branch restenosis remains a significant limitation in current therapeutic approaches. Coronary stents with a side aperture and a sleeve may be clinically advantageous to maintain access to side branch, stabilize the side-branch orifice, and deliver the appropriate drug to the side-branch ostium.
A novel stent system (PETAL stent; Advanced Stent Technologies, Pleasanton, CA), incorporating a side aperture with deployable struts, was compared within porcine coronary model to the prior stent version having only the side aperture (SLK-View stent). In six pigs, each stent was implanted either in the left anterior descending coronary artery or the left circumflex coronary artery with adjunctive kissing balloon dilatation. At 28-day follow-up, coronary angiography was performed.
A total of six SLK-View stents and six PETAL stents were implanted in coronary arteries without any complication, and adjunctive kissing balloon dilatations were successful in all lesions. Quantitative coronary angiography (QCA) data at 28 days showed that PETAL stents exhibited superior QCA in mean diameter compared with SLK-View stents for side branch, inferring efficacy of PETAL ostial struts.
AST-PETAL stent has the potential to be a new solution for treatment of bifurcation lesions. Antirestenosis drug elution should be considered with this successful platform.
在经皮治疗冠状动脉分叉病变时，边支再狭窄仍是当前治疗方法的一个重大局限。带有侧孔和套管的冠状动脉支架在临床上可能有利于保持边支通路、稳定边支开口，并将适当药物输送至边支开口处。
在猪冠状动脉模型中，将一种新型支架系统（花瓣支架；先进支架技术公司，加利福尼亚州普莱森顿）与仅带有侧孔的先前版本支架（SLK-View支架）进行比较，该新型支架系统带有可展开支柱的侧孔。在6头猪中，每个支架均植入左冠状动脉前降支或左旋支，并辅以球囊对吻扩张。在28天随访时，进行冠状动脉造影。
共在冠状动脉中植入6个SLK-View支架和6个花瓣支架，无任何并发症，且所有病变的球囊对吻扩张均成功。28天时的定量冠状动脉造影（QCA）数据显示，与SLK-View支架相比，花瓣支架在边支平均直径方面的QCA表现更优，这表明花瓣支架开口处支柱具有疗效。
AST-花瓣支架有可能成为治疗分叉病变的新解决方案。对于这个成功的平台，应考虑进行抗再狭窄药物洗脱。
