Double kissing mini-culotte versus mini-culotte stenting: insights from micro-computed tomographic imaging of bench testing

Hu, Fudong; Tu, Shengxian; Cai, Wei; Jiang, Zhengming; Zheng, Hong; Xiao, Liyan; Qiu, Chunyan; Xiong, Chao; Yao, Yaner; Chen, Lianglong

doi:10.4244/eij-d-18-00688

Cited by 18 publications

(11 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This polymeric BVS represents vessel patency and then to vanish resulting in a promising therapeutic strategy, named vascular restoration therapy(Refer to Figure 1 for the speci c process). The three differents culottebased stenting techniques: conventional culotte stenting (CCS, n=10) (Figure 2) Video 1 ; double kissing mini-culotte stenting (DKMCS, n=10) (Figure 3) Video 2 and double kissing single-ring culottes stenting (DKSRCS, n=10) (Figure 4) Video 3 were performed using previously reported methods in LePu Medical centralab 7 . BVS of 3.5 mm and 3.0 mm was used to stent the MB and SB, respectively.…”

Section: Experimental Protocolsmentioning

confidence: 99%

“…Although various Culotte-based stenting techniques (CSTs) exist, the ideal one remains undetermined. Bench testing using bifurcated coronary artery models can provide insights into stent morphologies and differences among CSTs, such as Conventional culotte stenting (CCS), double kissing miniculotte stenting (DKMCS), and double kissing single-ring culotte stenting (DKSRCS) using BVS, in terms of stent expansion and coverage across different bifurcation anatomies 6,7 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Improving Bifurcated Scaffold Morphologies: The Feasibility of Culotte Techniques with Bioresorbable Vascular Scaffolds

Tu,

Zhang,

Tian

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

Objectives: This study aimed to assess the bioresorbable vascular scaffold (BVS) performance with culotte stenting techniques and evaluate bifurcated scaffold morphologies. Methods: Conventional culotte stenting (CCS), double kissing mini-culotte stenting (DKMCS), and double kissing single-ring culotte stenting (DKSRCS) were executed in silicone bifurcated models. Procedures concluded with final kissing balloon inflation and proximal optimization technique. Microcomputed tomography assessed morphological parameters like side branch (SB) residual ostial stenosis and neocarina length (LNC) quantitatively. Optical coherence tomography (OCT) measured strut malapposition rates (SMR). Results: Quantitative assessments showed that BVS, in comparison with CCS, had significantly enhanced scaffold expansion at the SB ostium (6.29 ± 0.36 mm2 vs 6.71 ± 0.37 mm2, P = 0.05; 6.29 ± 0.36 mm2 vs 6.78 ± 0.26 mm2, P = 0.05, respectively), and decreased SB ostial stenosis(0.14% ± 0.04% vs 0.08% ± 0.04%, P < 0.05; 0.14% ± 0.04% vs 0.08 ± 0.03%, P < 0.05, respectively), LNC (0.49 ± 0.10 mm vs 0.30 ± 0.08 mm, P < 0.05; 0.49 ± 0.10 mm vs 0. 28 ± 0.06 mm, P < 0.05, respectively) and gap width(1.48 ± 0.06 mm vs 1.21 ± 0.06 mm, P < 0.05; 1.48 ± 0.06 mm vs 1.10 ± 0.04 mm, P < 0.05, respectively) in both DKMCS and DKSRCS. Notably, DKMCS and DKSRCS demonstrated reduced SMR, especially in scaffold overlap areas, as revealed by OCT. Conclusions: DKMCS and DKSRCS offer superior morphological outcomes for BVS models than CCS, suggesting BVS as a viable and effective technique for culotte stenting.

show abstract

Section: Experimental Protocolsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improving Bifurcated Scaffold Morphologies: The Feasibility of Culotte Techniques with Bioresorbable Vascular Scaffolds

Tu,

Zhang,

Tian

et al. 2024

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…The DMV should be wired from the closest cell to the carina for the reasons described above (Figure 11D ); (5) Stent struts are opened by a DMV balloon. Instead, KBI, which is part of the recently introduced “DK-culotte technique”, can be performed[ 89 , 90 ] (Figure 11E ). This technique was found to achieve better morphological properties than classical culotte stenting in a bench test study[ 89 ], and it reduced the total procedural time with better strut apposition than the culotte and even the DK-crush techniques in another study[ 90 ]; (6) An MV stent sized 1:1 to the DMV diameter is advanced and implanted.…”

Section: Elective Double Stenting Techniquesmentioning

confidence: 99%

“…Instead, KBI, which is part of the recently introduced “DK-culotte technique”, can be performed[ 89 , 90 ] (Figure 11E ). This technique was found to achieve better morphological properties than classical culotte stenting in a bench test study[ 89 ], and it reduced the total procedural time with better strut apposition than the culotte and even the DK-crush techniques in another study[ 90 ]; (6) An MV stent sized 1:1 to the DMV diameter is advanced and implanted. The length of the PMV part should be sufficient to cover the PMV part of the SB and be at least equal to the shortest POT balloon (Figure 11F ); (7) A second POT is performed in the PMV (Figure 11G ); (8) A second wire exchange is performed by passing the MV wire through the closest cell to the carina into the SB and the U-shaped SB wire into the DMV (Figure 11H ); (9) KBI is performed with short non-compliant balloons sized 1:1 to the branches.…”

Section: Elective Double Stenting Techniquesmentioning

confidence: 99%

Fundamentals of percutaneous coronary bifurcation interventions

Kırat¹

2022

WJC

View full text Add to dashboard Cite

Coronary bifurcation lesions (CBLs) account for 15%-20% of all percutaneous coronary interventions. The complex nature of these lesions is responsible for poorer procedural, early and late outcomes. This complex lesion subset has received great attention in the interventional cardiac community, and multiple stenting techniques have been developed. Of these, the provisional stenting technique is most often the default strategy; however, the elective double stenting (EDS) technique is preferred in certain subsets of complex CBLs. The double kissing crush technique may be the preferred EDS technique because of its efficacy and safety in comparative trials; however, this technique consists of many steps and requires training. Many new methods have recently been added to the EDS techniques to provide better stent scaffolding and to reduce early and late adverse outcomes. Intravascular imaging is necessary to determine the interventional strategy and postinterventional results. This review discusses the basic concepts, contemporary percutaneous interventional technical approaches, new methods, and controversial treatment issues of CBLs.

show abstract

“…[39] More recently, a chain of modified Culotte stenting has been proposed, mainly including mini-Culotte [40] and double-kissing culotte (DK Mini-Culotte). [41,42] DK Mini-culotte for true bifurcation lesions is superior to PS in the reduction of target lesion revascularization (TLR)/target vessel revascularization (TVR) and SB restenosis, and the treatment effect of those 2 modified culotte stenting is comparable to other 2-stent techniques. [42,43] Nevertheless, randomized controlled trials are needed to warrant the efficacy of modified culotte stenting.…”

Section: Culotte Stentingmentioning

confidence: 99%

Chinese Guideline for Percutaneous Coronary Intervention in Patients with Left Main Bifurcation Disease

2022

Cardiology Discovery

View full text Add to dashboard Cite

The coronary left main (LM) artery is characterized by large caliber, length varying from <8 to >15 mm, and 2 large daughter vessels branching from it; it supplies blood to a large area (>75%) of the myocardium. LM bifurcation lesion is defined as the presence of atherosclerosis involving either or both of the 2 daughter vessels. Thus, the optimal strategy of revascularization for diseased LM has been an interesting research topic for a long time. With developments in percutaneous techniques, design, and materials of drug-eluting stents; intravascular imaging; new generation of antiplatelet medications; and particularly recent pooled evidence from randomized clinical trials comparing percutaneous coronary intervention with coronary artery bypass grafting, implantation of a drug-eluting stenting with or without other approved techniques is considered an important therapeutic approach for LM bifurcation lesions. Mirroring the anatomical complexity of the LM, stenting LM bifurcations is technically demanding, and intraprocedural complications can be catastrophic given the large amount of jeopardized myocardium. Therefore, the Chinese Society of Cardiology designed a writing committee with members from 3 working groups (ie, clinical research, intravascular imaging and physiology, and interventional cardiology) for the first time, to write a guideline on percutaneous treatment for LM bifurcation lesions, with view to improve the procedural quality and clinical outcomes. This guideline consists of introduction, anatomical description of the LM tree, risk stratification, strategies of revascularization, antiplatelet strategy, follow-up, and longterm management for patients with LM bifurcation lesions.

show abstract

Double kissing mini-culotte versus mini-culotte stenting: insights from micro-computed tomographic imaging of bench testing

Cited by 18 publications

References 22 publications

Improving Bifurcated Scaffold Morphologies: The Feasibility of Culotte Techniques with Bioresorbable Vascular Scaffolds

Improving Bifurcated Scaffold Morphologies: The Feasibility of Culotte Techniques with Bioresorbable Vascular Scaffolds

Fundamentals of percutaneous coronary bifurcation interventions

Chinese Guideline for Percutaneous Coronary Intervention in Patients with Left Main Bifurcation Disease

Contact Info

Product

Resources

About