Royal Brompton Hospital, London, United Kingdom.
EuroIntervention. 2009 Nov;5(5):544-51. doi: 10.4244/eijv5i5a89.
Dedicated bifurcation stents should facilitate deployment and improve coverage of bifurcational lesions. We used optical coherence tomography (OCT) to assess bifurcation lesions treated with a dedicated stent implanted in the side branch (SB) in conjunction with drug eluting stents in the main vessel (MV) in a culotte-like fashion.
Nine patients treated with the Tryton stent underwent postprocedural OCT examination. Total percent of malapposed struts per patient was 18.1+/-8.7%. The longitudinal distribution of the percent of malapposed struts per patient showed that the prevalence of malapposed struts was significantly higher at the level of the bifurcation (33.3%), than in both the proximal segment and the distal segment (18.5% and 9.8%, respectively, p=0.011). When the bifurcation was divided into two halves (opposite SB and toward SB), the highest percent of malapposed struts was toward the SB (47.6%). Also the wall-strut distance for malapposed struts was significantly higher in the bifurcation half toward the SB than in the proximal and the distal segment.
Malapposed struts are frequent in bifurcations despite the use of a dedicated stent. The highest frequency and largest vessel wall-stent strut distance are observed in the bifurcation half toward the SB.
专用分叉支架有助于实现分叉病变的准确定位和充分覆盖。我们使用光学相干断层扫描（OCT）评估了一种专用支架，该支架被用于分叉病变，其在分支血管（SB）内的植入方式类似于“三明治”技术，同时在主血管（MV）内植入药物洗脱支架。
9 名接受 Tryton 支架治疗的患者进行了术后 OCT 检查。每位患者的支架贴壁不良比例为 18.1±8.7%。患者支架贴壁不良比例的纵向分布表明，分叉部位支架贴壁不良的发生率明显高于近端段和远端段（分别为 33.3%、18.5%和 9.8%，p=0.011）。当将分叉部位分为两半（对向 SB 和朝向 SB）时，朝向 SB 的支架贴壁不良比例最高（47.6%）。此外，朝向 SB 的分叉半段的支架贴壁不良的血管-支架壁距离明显大于近端段和远端段。
尽管使用了专用支架，但分叉部位仍存在支架贴壁不良的情况。在朝向 SB 的分叉半段，支架贴壁不良的发生率和血管-支架壁距离最大。
