Interference Between Pressure-Wire and Deployed Coronary Stents: Insights from a Bench Test.

Autor: Warisawa T; National Heart and Lung Institute, Imperial College London, London, UK; Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan. Electronic address: warisawa-tky@umin.ac.jp., Nour D; National Heart and Lung Institute, Imperial College London, London, UK; James Cook University, Queensland, Australia., Seligman H; National Heart and Lung Institute, Imperial College London, London, UK., Doi S; Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan., Kuwata S; Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan., Howard JP; National Heart and Lung Institute, Imperial College London, London, UK., Rajkumar C; National Heart and Lung Institute, Imperial College London, London, UK., Cook CM; National Heart and Lung Institute, Imperial College London, London, UK., Nakayama Y; Department of Cardiovascular Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan., Kasahara M; Department of Cardiovascular Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan., Suzuki N; Department of Cardiovascular Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan., Matsuda H; Department of Cardiovascular Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan., Mizuno K; Department of Cardiovascular Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan., Akashi YJ; Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Jazyk: angličtina
Zdroj: Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2020 Jun; Vol. 21 (6), pp. 765-770. Date of Electronic Publication: 2019 Oct 27.
DOI: 10.1016/j.carrev.2019.10.026
Abstrakt: Background: While several complications related to pressure-wire (PW) have been reported, mechanistic justification has not always been offered. Furthermore, interference between a PW and a protruding side-branch stent has not been previously reported. The purpose of this study was to evaluate interference between PW-pullback from a main-branch with a protruded ostial stent deployed in a side-branch.
Methods: In a polyurethane bifurcation vessel model, PW-pullback was performed in a main-branch following protruded ostial stenting in a side-branch. Tested PWs included PressureWire X, Comet, OptoWire, and Verrata. For each PW, pullback was performed through the same proximal cell of the protruded stent 20 times. Interference during PW-pullback was objectively analyzed with a fiberscope placed at the distal main-branch and classified into 3 grades according to the interaction with stent strut.
Results: There were significant differences in the rate of interference between the PWs. No-interference, interference without strut traction, and interference with strut traction (i.e. stent deformation) were observed as follows: 17/20, 3/20, and 0/20 in PressureWire X; 19/20, 1/20, and 0/20 in Comet; 8/20, 10/20, and 2/20 in OptoWire; and 13/20, 2/20, and 5/20 in Verrata, respectively (p for any differences: <0.001). Visually identifiable major stent deformation was observed once in OptoWire due to the deep concave sensor window and twice in Verrata due to the proximal gap between the sensor and coiled-wire.
Conclusions: PW-pullback in the main-branch after side-branch ostial stenting should be carefully performed to avoid stent deformation. Consideration on the specific mechanical features of the PW is also essential.
Competing Interests: Declaration of competing interest TW reports consultancies work for Abbott Vascular and Philips. HS has received research funding from Amgen. J.P. Howard is supported by the Wellcome Trust (212183/Z/18/Z). CMC has received speaker's honoraria from Philips.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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