Postdilation Strategies Following Provisional Stenting of Left Main Coronary Bifurcations
- validated computational simulations
- patient-specific
- reconstructed in three dimensions and virtually stented
+2 more
- patient-specific
- reconstructed in three dimensions and virtually stented
Authors' conclusion
KBI is superior to P or P-S-P. Combined high-pressure sequential and nominal-pressure simultaneous KBI outperforms sequential or simultaneous KBI alone, particularly in stiff calcified or fibrous lesions. Final POT after KBI provides no incremental advantage.
Study context
- Population
- Patient-specific left main (LM) bifurcations treated with provisional stenting
- Participants
- Four patient-specific LM bifurcations
- Comparison
- Techniques were compared based on lumen/stent morphology and hemodynamics.
Main finding
As reported in the abstract
Overall ranking of P vs other techniques: smaller ostial area with P compared with other techniques
27%
larger area exposed to high wall shear stress gradient at the left circumflex ostium with P compared with other techniques
76%
Further findings
P-S-P ranking (left anterior descending artery ostium)
- greater area exposed to high relative residence time at the left anterior descending artery ostium with P-S-P
- 29%
- P-S-P ranked second lowest
- P-S-P ranking: 14% smaller ostial area and 29% greater area exposed to high relative residence time at the left anterior descending artery ostium
Techniques incorporating kissing balloon inflation (KBI)
- Techniques incorporating KBI showed the most favorable performance, with combined sequential and simultaneous KBI performing best, particularly in calcified or fibrous plaques
Final proximal optimization technique (POT) after KBI
- Final POT after KBI did not confer incremental benefit
Original publication
Summarised from the published abstract; every number is checked against it