Complex coronary bifurcation revascularization by means of very minimal crushing and ultrathin biodegradable polymer DES: Feasibility and 1-year outcomes of the “Nano-crush” technique

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• 作者：Gianluca Rigatelli^a ; ^{jackyheart@libero.it} ; Fabio Dell'Avvocata^a ; Marco Zuin^b ; Dobrin Vassiliev^c ; Alberto Mazza^b ; Huy D. Dinh^d
• 关键词：Coronary bifurcation ; PCI ; Stent ; Crush ; Interventional
• 刊名：Cardiovascular Revascularization Medicine
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：18
• 期：1
• 页码：22-27
• 全文大小：699 K
• 卷排序：18

文摘

To assess feasibility and 1-year outcomes of ultrathin biodegradable polymer double stenting using a very minimal crushing (nano-crush technique) in a series of patients with large (≥2.5 mm) complex coronary bifurcation.MethodsFrom January 2015 to June 2016, patients referred for large (≥2.5 mm) complex coronary bifurcation percutaneous coronary interventions (PCI) were enrolled to receive Orsiro (Biotronik Inc., Bulack, Switzerland) double stenting using a very minimal crush technique (nano-crush). Per our institutional protocol, follow-up was conducted by physical examination at 1, 6, 12 month and yearly whereas angiographic control was eventually scheduled at 6–8 months on the basis of symptoms recurrence or/and positive induced ischemia tests.ResultsFifty-two patients (15 females mean age 77.2 ± 6.2 years) were enrolled. Mean angles between main branch and side branch were 63.6 ± 21.3°. The mean diameter and length of implanted stents were 3.8 ± 0.4 mm and 27.1 ± 8.7 mm in main branch and 2.8 ± 0.3 mm and 22.1 ± .7.1 mm in side branch. Immediate success was 100%. Clinical follow-up was available for 100% of patients: at a mean follow-up of 12.0 ± 2.6 months, no patient death, or acute myocardial infarction or target vessel revascularization were observed. Angiographic follow-up was available in 25/52 patients (48%) at a mean time from the procedure of 7.2 ± 0.5 months and showed no significant angiographic restenosis.ConclusionsThe revascularization of complex large (≥2.5 mm) coronary bifurcation disease using the nano-crush technique and the ultrathin polymer biodegradable stent appeared feasible in our small study with promising 1 year outcomes.