Reliability and Safety of a Side-Branch Jailed Second-Generation Optical-Pressure Guidewire in a Physiology-Guided Bifurcation-PCI In Vitro Model.
Details
Serval ID
serval:BIB_CAFF9962A14C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Reliability and Safety of a Side-Branch Jailed Second-Generation Optical-Pressure Guidewire in a Physiology-Guided Bifurcation-PCI In Vitro Model.
Journal
The Journal of invasive cardiology
ISSN
1557-2501 (Electronic)
ISSN-L
1042-3931
Publication state
Published
Issued date
08/2022
Peer-reviewed
Oui
Volume
34
Number
8
Pages
E594-E600
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
The treatment of a coronary bifurcation with a single stent (the provisional stenting technique) is associated with a good outcome in most cases. In the majority of cases, after provisional stenting technique, a residual significant angiographic stenosis is associated with the absence of ischemia when fractional flow reserve (FFR) is measured. Jailing an optical pressure guidewire in the side branch (SB) could potentially reduce unnecessary SB interventions after provisional stenting technique. The aim of this study was to compare distal pressure to aortic pressure ratio (Pd/Pa) measurements between 2 second-generation optical pressure guidewires in bifurcation treatment-a jailed wire (JW) and a second free-floating wire (FW) advanced into the SB after stenting.
In an in vitro bifurcation hydrodynamic model with pressure sensors, a JW was advanced into the SB and the FW into the main branch. Bifurcation stenting is performed with the proximal optimization technique (POT)-side-POT technique using a 3.0 x 22-mm stent, a 4.0 x 12-mm noncompliant balloon for the POT, and a 2.5 x 12-mm semicompliant balloon for the SB opening. The same steps were performed in a second model where a surgical clamp was placed in the main vessel to lower overall absolute values pressures.
A strong correlation was found between JW and FW values (Pearson's coefficient, r=0.91). All wires could be safely retrieved.
In bifurcation stenting, the Pd/Pa value of a second-generation optical pressure guidewire jailed in the SB is reliable compared with a FW inserted after stent implantation.
In an in vitro bifurcation hydrodynamic model with pressure sensors, a JW was advanced into the SB and the FW into the main branch. Bifurcation stenting is performed with the proximal optimization technique (POT)-side-POT technique using a 3.0 x 22-mm stent, a 4.0 x 12-mm noncompliant balloon for the POT, and a 2.5 x 12-mm semicompliant balloon for the SB opening. The same steps were performed in a second model where a surgical clamp was placed in the main vessel to lower overall absolute values pressures.
A strong correlation was found between JW and FW values (Pearson's coefficient, r=0.91). All wires could be safely retrieved.
In bifurcation stenting, the Pd/Pa value of a second-generation optical pressure guidewire jailed in the SB is reliable compared with a FW inserted after stent implantation.
Keywords
Coronary Angiography, Coronary Artery Disease/therapy, Coronary Stenosis/diagnosis, Coronary Stenosis/surgery, Coronary Vessels/diagnostic imaging, Coronary Vessels/surgery, Fractional Flow Reserve, Myocardial, Humans, Percutaneous Coronary Intervention/adverse effects, Percutaneous Coronary Intervention/methods, Reproducibility of Results, Stents, Treatment Outcome, coronary bifurcation, fractional flow reserve, optical pressure guidewire, side branch
Pubmed
Create date
18/07/2022 9:32
Last modification date
25/08/2022 6:41