Department for Cardiology, Center for Internal Medicine, University Medical Center Rostock, Ernst-Heydemann-Straße 6, 18057, Rostock, Germany.
Institute for Implant Technology and Biomaterials-IIB E.V, Associated Institute of the University of Rostock, Warnemuende, Rostock, Germany.
Eur J Med Res. 2021 Oct 12;26(1):121. doi: 10.1186/s40001-021-00595-7.
Percutaneous coronary interventions (PCI) of bifurcation stenoses are both complex and challenging. Stenting strategies share that the stents' side cells must be carefully explored and appropriately prepared using balloons or stents. So far, stent manufacturers have not provided any information regarding side-branch expansion capacity of their stent platforms.
Given that drug-eluting stent (DES) information regarding their mechanical capacity of side-branch expansion is not available, we aimed to evaluate contemporary DES (Orsiro, BIOTRONIK AG; Xience Sierra, Abbott Vascular; Resolute Integrity, Medtronic; Promus Premier Select, Boston Scientific; Supraflex Cruz, Sahajan and Medical Technologies) by their side-branch expansion behavior using in vitro bench testing.
In this in vitro study, we analyzed five commercially available DES (diameter 3.0 mm), measuring their side-branch expansion following inflation of different high-pressure non-compliant (NC) balloons (balloon diameter: 2.00-4.00 mm), thereby revealing the morphological characteristics of their side-branch expansion capacities.
We demonstrated that all tested contemporary DES platforms could withstand large single-cell deformations, up to 4.0 mm. As seen in our side-branch experiments, DES designs consisting of only two connectors between strut rings did not only result in huge cell areas, but also in larger cell diameters following side-branch expansion compared with DES designs using three or more connectors. Furthermore, the stent cell diameter attained was below the balloon diameter at normal pressure.
We recommend that the expansion capacity of side-branches should be considered in stent selection for bifurcation interventions.
经皮冠状动脉介入治疗（PCI）的分叉病变既复杂又具有挑战性。支架策略的共同点是，必须仔细探索支架的侧支细胞，并使用球囊或支架进行适当准备。到目前为止，支架制造商尚未提供任何关于其支架平台侧支扩张能力的信息。
鉴于药物洗脱支架（DES）没有关于其侧支扩张机械能力的信息，我们旨在通过体外 bench 测试评估当代 DES（Orsiro，BIOTRONIK AG；Xience Sierra，Abbott Vascular；Resolute Integrity，Medtronic；Promus Premier Select，Boston Scientific；Supraflex Cruz，Sahajan 和 Medical Technologies）的侧支扩张行为。
在这项体外研究中，我们分析了五种市售的 DES（直径 3.0mm），在膨胀不同高压非顺应性（NC）球囊（球囊直径：2.00-4.00mm）后测量其侧支扩张，从而揭示其侧支扩张能力的形态特征。
我们证明，所有测试的当代 DES 平台都可以承受大的单个细胞变形，最大可达 4.0mm。正如我们在侧支实验中看到的，由两个连接体之间的连接体组成的 DES 设计不仅导致了巨大的细胞区域，而且与使用三个或更多连接体的 DES 设计相比，在侧支扩张后还导致了更大的细胞直径。此外，在正常压力下，达到的支架细胞直径低于球囊直径。
我们建议在分叉介入治疗的支架选择中应考虑侧支的扩张能力。
