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使用光学相干断层扫描评估一种分叉病变治疗新策略:Tryton 分支支架。

Assessment with optical coherence tomography of a new strategy for bifurcational lesion treatment: the Tryton Side-Branch Stent.

作者信息

Ferrante Giuseppe, Kaplan Aaron V, Di Mario Carlo

机构信息

Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.

出版信息

Catheter Cardiovasc Interv. 2009 Jan 1;73(1):69-72. doi: 10.1002/ccd.21803.

Abstract

The Tryton-Side Branch Stent (Tryton Medical, Inc., Newton, MA, USA) is a dedicated stent designed to provide complete carinal coverage of bifurcational lesions. After implantation of a 18 mm cobalt chromium Tryton stent from the left circumflex into the obtuse marginal branch, recrossing with an everolimus eluting Promus stent and final kissing balloon dilatation, optical coherence tomography (OCT) (LightLab Imaging Inc., Westford, MA, USA) was performed with a non-occlusive technique with motorized pullback (3 mm/s) during continuous pump injection of iso-osmolar contrast, in both LCx and OM1. OCT imaging showed good strut apposition at the level of the carina, with full coverage and no stent protrusion at the ostium of the side branch. Few malapposed struts were present in the proximal main vessel in the segment of stent superimposition, with a maximal separation from to the vessel wall of 160 microm. The implantation of the Tryton-Side Branch Stent allowed full coverage of the side branch ostium with uniform apposition of the stent struts at the level of the carina assessed by OCT.

摘要

Tryton 侧支支架(美国马萨诸塞州牛顿市 Tryton 医疗公司)是一种专门设计用于完全覆盖分叉病变隆突的支架。在将一个 18 毫米的钴铬合金 Tryton 支架从左旋支植入钝缘支后,用依维莫司洗脱的 Promus 支架再次穿过并进行最终的球囊对吻扩张,然后在左旋支(LCx)和第一钝缘支(OM1)中,在持续泵注等渗造影剂的过程中,采用非闭塞技术和电动回撤(3 毫米/秒)进行光学相干断层扫描(OCT,美国马萨诸塞州韦斯特福德市 LightLab 成像公司)。OCT 成像显示在隆突水平支架梁贴靠良好,侧支开口处完全覆盖且无支架突出。在支架重叠段的近端主血管中存在少量贴靠不良的支架梁,与血管壁的最大间距为 160 微米。Tryton 侧支支架的植入使得侧支开口完全被覆盖,通过 OCT 评估在隆突水平支架梁均匀贴靠。

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