Stent Deformation Caused by Entrapment of the Side Branch Balloon Catheter During the Jailed Balloon Protection Technique for a Calcified Coronary Bifurcation Lesion: A Case Report and Literature Review

Aims: A novel stent was designed for the treatment of coronary bifurcation lesion, and it was investigated for its performance by finite element analysis. This study was performed in search of a novel method of treatment of bifurcation lesion with provisional stenting. Methods: A coronary bifurcation model was created with the proximal vessel of 3.2 mm diameter, and the distal vessel after the side branch (2.3 mm) was 2.7 mm. A novel stent was designed with connections that had a profile of a tram. Laser cutting and shape setting of the stent was performed, and thereafter it was crimped and deployed over a balloon. The contact pressure, stresses on the arterial wall, stresses on the stent, the maximal principal log strain of the main artery and the side-branch were studied. Also multiple designs were tested in the tram area to suite the standard crimping. The study was performed in Abaqus. A firm lesion model with a stenosis of about 75% was then created with a discrete lesion in the sidebranch and the main vessel. The accompanying figure shows the model used for evaluation. Results: The stresses on the main branch and the distal branch were minimally increased after deployment of this stent. The side branch was preserved, and the stresses on the side branch were lesser; and at the confluence of bifurcation on either side of the side branch origin the Von Mises stresses were marginally increased as shown in figure. However, the stresses at the bifurcation and in the main branch were significantly lesser than the stresses by the existing techniques used in the treatment of bifurcation lesions. Conclusions: There is a potential for a novel Tram-stent method in the treatment of coronary bifurcation lesions.

Download Full-text

TCT-13: Side Branch Ballooning After Main Vessel Stenting May Increase The Long-term Risk Of Target Lesion Revascularization Rate In The Coronary Bifurcation Lesion

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2010.08.018 ◽

2010 ◽

Vol 56 (13) ◽

pp. B3

Keyword(s):

Target Lesion ◽

Side Branch ◽

Target Lesion Revascularization ◽

Coronary Bifurcation ◽

Bifurcation Lesion ◽

Main Vessel ◽

Coronary Bifurcation Lesion

Download Full-text

Side-branch technique for difficult guidewire placement in coronary bifurcation lesion

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2015.03.005 ◽

2016 ◽

Vol 17 (1) ◽

pp. 59-62 ◽

Cited By ~ 1

Author(s):

Xingwei He ◽

Bo Gao ◽

Yujian Liu ◽

Zhuxi Li ◽

Hesong Zeng

Keyword(s):

Side Branch ◽

Coronary Bifurcation ◽

Bifurcation Lesion ◽

Coronary Bifurcation Lesion

Download Full-text

TCTAP A-039 The New Possibility of the Glider Balloon As a Side Branch Treatment in the Coronary Bifurcation Lesion Beyond the Kissing Balloon Inflation

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2015.03.091 ◽

2015 ◽

Vol 65 (17) ◽

pp. S19

Author(s):

Masaaki Nishihara ◽

Yoshinobu Murasato

Keyword(s):

Side Branch ◽

Coronary Bifurcation ◽

Balloon Inflation ◽

Bifurcation Lesion ◽

Coronary Bifurcation Lesion

Download Full-text

Treatment of a Coronary Bifurcation Lesion Using One Dedicated Sirolimus Eluting Bifurcation Stent in Combination with a Bioresorbable Vascular Scaffold: A Novel Option for Coronary Bifurcation Approach

Case Reports in Cardiology ◽

10.1155/2016/8402942 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4

Author(s):

Javier Benezet ◽

Antonio Agarrado ◽

Jesús Oneto

Keyword(s):

Large Cell ◽

Side Branch ◽

Coronary Bifurcation ◽

Bioresorbable Vascular Scaffold ◽

Standard Size ◽

Bifurcation Lesion ◽

Vascular Scaffold ◽

Bifurcation Stent ◽

Coronary Bifurcation Lesion

We present a complex bifurcation lesion treated with a new two-stent strategy combining a dedicated sirolimus eluting bifurcation stent, BiOSS Lim, with a bioresorbable vascular scaffold (BVS). The advantages of this strategy compared with the conventional two-stent approach are as follows: the dedicated stent protects the carina from being damaged, the large cell at the middle zone of the BiOSS Lim gives possibility to enter easily into the side branch (SB) with any standard size conventional device, and, finally, the additional use of BVS in the SB could have a long-term benefit in terms of restenosis.

Download Full-text