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Reliability and Safety of a Side-Branch Jailed Second-Generation Optical-Pressure Guidewire in a Physiology-Guided Bifurcation-PCI In Vitro Model.
Rubimbura, Vladimir; Johnson, Nils; Van't Veer, Marcel; Adjedj, Julien; Fournier, Stephane; Dupré, Marion; De Bruyne, Bernard; Eeckhout, Eric; Muller, Olivier.
Afiliación
  • Rubimbura V; Cardiology Department, Lausanne University- Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland. vladimir.rubimbura@chuv.ch.
J Invasive Cardiol ; 34(8): E594-E600, 2022 08.
Article en En | MEDLINE | ID: mdl-35830360
BACKGROUND: 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. METHODS: 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. RESULTS: A strong correlation was found between JW and FW values (Pearson's coefficient, r=0.91). All wires could be safely retrieved. CONCLUSION: 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.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Estenosis Coronaria / Reserva del Flujo Fraccional Miocárdico / Intervención Coronaria Percutánea Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: J Invasive Cardiol Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Estenosis Coronaria / Reserva del Flujo Fraccional Miocárdico / Intervención Coronaria Percutánea Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: J Invasive Cardiol Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Estados Unidos