Vasile SirbuJilin Heart Hospital, China
Title: Optical coherence tomography to assess proximal side optimization technique in crush stenting for true bifurcation coronary lesions
Aim: We analyzed the previously described intraprocedural benefits of Proximal Side Optimization (PSO) technique with Optical Coherence Tomography (OCT).
Methods: Ten consecutive true bifurcation lesions with severe long pathology of long side branch were randomly assigned to be treated by standard DK Crush procedure as compared to DK Crush in PSO modification. Data from OCT investigation before crushing of the SB DES, after crushing and after first kissing balloon inflation were compared between the two groups. The time needed for first rewiring, second rewiring, contrast material and radiation load were collected.
Results: All ten cases were successfully treated by the assigned technique. The two groups were similar in terms of indications for the procedure, bifurcation angle and stent dimensions. As compared to DK Crush, the PSO group showed larger proximal SB stent areas, larger delta between distal and proximal stent areas before crush, larger Space of Optimal Wiring (SOW) after Crush. The time needed for first and second rewiring as well as the amount of contrast material and radiation load were significantly less in the PSO group.
Conclusion: The DK Crush in PSO modification results in larger SB DES and SOW areas. Less time, material and radiation load are needed to successfully complete the procedure while using this simple modification.
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