Division of Cardiology, Toyohashi Heart Center, Toyohashi, Aichi, Japan.
JACC Cardiovasc Interv. 2010 Jan;3(1):58-65. doi: 10.1016/j.jcin.2009.09.016.
We sought to report the results of both bench-testing and our first clinical experience with this novel technique.
The optimal stenting technique for bifurcation lesions has yet to be defined.
This technique works by flaring the proximal side of the stent in side branch out like a flower petal. We tested it in vitro and the resultant stent structure and stent polymer damage was observed in both main branch and side branch with an optical microscopy, multislice computer tomography, intravascular ultrasound, endoscopy, and by electron microscopy. We also applied this technique in 33 patients and assessed patient outcomes up to 9 months prospectively. Drug-eluting stents were used for the bench tests and for all patients.
Bench-testing showed complete coverage of the bifurcation with minimal stent-layer overlapping. There was little polymer damage by electron microscopy. Procedural success was achieved in all cases and restenosis occurred in 2 cases. In both restenosis cases, "petal" stenting technique was done reluctantly after another stent had already been deployed in the main branch before any stenting of the side branch. There were no incidences of restenosis when this technique was used electively.
In terms of damage to the polymer and ostial strut coverage, this new "flower petal stenting" technique is effective for treatment of bifurcation lesion and it may well be superior to other available techniques.
我们旨在报告这项新技术的体外测试结果和初步临床经验。
分叉病变的最佳支架置入技术尚未确定。
该技术通过将支架的近端像花瓣一样在分支处展开来扩张。我们在体外进行了测试，并通过光学显微镜、多层计算机断层扫描、血管内超声、内窥镜和电子显微镜观察到主支和分支处的支架结构和支架聚合物损伤。我们还将该技术应用于 33 例患者，并前瞻性评估了 9 个月的患者预后。体外测试和所有患者均使用药物洗脱支架。
体外测试显示完全覆盖分叉，支架层重叠最小。电子显微镜显示聚合物损伤较小。所有病例均获得技术成功，有 2 例发生再狭窄。在这 2 例再狭窄病例中，在主支内已经置入一个支架后，才不情愿地对侧支进行“花瓣”支架置入术。选择性使用该技术时，无再狭窄发生。
在聚合物损伤和开口支架覆盖方面，这种新的“花瓣支架置入”技术对分叉病变的治疗有效，可能优于其他现有技术。
