Coronary bifurcation stenting: insights from in vitro and virtual bench testing.

The various techniques and devices that have been proposed for the treatment of coronary bifurcation lesions have differing levels of complexity and each has one or more limitations. Two highly complementary ex vivo methods are available to study the treatment of bifurcation lesions: in vitro and virtual bench testing. Both methods can be used to develop, evaluate and optimise bifurcation stenting techniques and dedicated devices. The basics, the evolution, the advantages and limitations of both methods are discussed in this paper. Subsequently, a literature overview of the main insights gained from ex vivo testing in the field of bifurcation stenting is given.

[1]  Y. Murasato Impact of three‐dimensional characteristics of the left main coronary artery bifurcation on outcome of crush stenting , 2007, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[2]  J. Feijen,et al.  Micro-computed tomographic assessment following extremely oversized partial postdilatation of drug-eluting stents. , 2010 .

[3]  E. Romagnoli,et al.  Modified T‐stenting with intentional protrusion of the side‐branch stent within the main vessel stent to ensure ostial coverage and facilitate final kissing balloon: The T‐stenting and small protrusion technique (TAP‐stenting). Report of bench testing and first clinical Italian‐Korean two‐centre exp , 2007, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[4]  F. Kajiya,et al.  Recent perspective on coronary bifurcation intervention: statement of the "Bifurcation Club in KOKURA". , 2010, Journal of interventional cardiology.

[5]  John A Ormiston,et al.  The "crush" technique for coronary artery bifurcation stenting: insights from micro-computed tomographic imaging of bench deployments. , 2008, JACC. Cardiovascular interventions.

[6]  H. White,et al.  Stent deformation following simulated side‐branch dilatation: A comparison of five stent designs , 1999, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[7]  Y. Otsuji,et al.  Three‐dimensional modeling of double‐stent techniques at the left main coronary artery bifurcation using micro‐focus X‐ray computed tomography , 2007, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[8]  Y. Murasato Bench Testing of Coronary Bifurcation Stenting Techniques: How Is It Done? Does It Help Technical Decision Making? , 2010 .

[9]  I. Moussa,et al.  Tips and Tricks in Interventional Therapy of Coronary Bifurcation Lesions , 2010 .

[10]  Pascal Verdonck,et al.  A Novel Simulation Strategy for Stent Insertion and Deployment in Curved Coronary Bifurcations: Comparison of Three Drug-Eluting Stents , 2009, Annals of Biomedical Engineering.

[11]  Gabriele Dubini,et al.  Modelling of the provisional side-branch stenting approach for the treatment of atherosclerotic coronary bifurcations: effects of stent positioning , 2010, Biomechanics and modeling in mechanobiology.

[12]  Peter Mortier,et al.  Computer modelling of coronary bifurcation stenting , 2010 .

[13]  Douglas Scott,et al.  Drug‐eluting stents for coronary bifurcations: Bench testing of provisional side‐branch strategies , 2006, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[14]  J. Ormiston,et al.  The AST petal dedicated bifurcation stent: First‐in‐human experience , 2007, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[15]  K. Node,et al.  Benefits and limitations of cypher stent-based bifurcation approaches: in vitro evaluation using micro-focus CT scan. , 2009, Journal of interventional cardiology.

[16]  Y. Kobayashi,et al.  Difference in security of stent jail between Palmaz‐Schatz, NIR, and multi‐link stents: The effect of balloon inflation through stent struts , 1999, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[17]  E. Currie,et al.  Drug‐eluting stents for coronary bifurcations: Insights into the crush technique , 2004, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[18]  G. Finet,et al.  Drug-Eluting Stents in Bifurcations: Bench Study of Strut Deformation and Coating Lesions , 2010, Circulation. Cardiovascular interventions.

[19]  Pascal Verdonck,et al.  Finite element analysis of side branch access during bifurcation stenting. , 2009, Medical engineering & physics.

[20]  Y. Murasato,et al.  Examination of stent deformation and gap formation after complex stenting of left main coronary artery bifurcations using microfocus computed tomography. , 2009, Journal of interventional cardiology.

[21]  Pascal Verdonck,et al.  Comparison of drug-eluting stent cell size using micro-CT: important data for bifurcation stent selection. , 2008, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.