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Serial intravascular ultrasound analysis of complex bifurcation coronary lesions treated with the tryton bifurcation stent in conjunction with an everolimus‐eluting stent: IUVANT (Intravascular ultrasound evaluation of tryton stent) study
Author(s) -
Bartorelli Antonio L.,
Trabattoni Daniela,
Almonacid Alexandra,
Fabbiocchi Franco,
Montorsi Piero,
Galli Stefano,
Grancini Luca,
Ravagnani Paolo,
Mintz Gary S.,
Kaplan Aaron V.,
Popma Jeffrey J.,
Maehara Akiko
Publication year - 2015
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25629
Subject(s) - medicine , intravascular ultrasound , stent , restenosis , radiology , lumen (anatomy) , everolimus , neointimal hyperplasia , cardiology , nuclear medicine
Objectives To characterize the treatment of complex bifurcation lesions (BL) with the Tryton Bifurcation Stent (TBS) paired with an everolimus‐eluting stent (EES). Background Complex BL are associated with higher procedural complications and poorer long‐term outcomes. The TBS is a dedicated side‐branch (SB) stent designed to be used in conjunction with a standard drug‐eluting stent. Methods Prospectively identified, consecutive patients underwent TBS+EES stenting of BL using a protocol which included TBS postdilation and simultaneous final kissing balloon inflations (FKBI). All lesions were systematically evaluated with coronary angiography and IVUS, obtained at procedure completion and at 9 months, and were assessed by independent core laboratories. Results Thirty‐three BL were treated in 32 patients presenting primarily (87.5%) with stable angina and complex BL with angiographic apparent disease in the main vessel (MV) and SB in 87.9% and 75% by site and core evaluation, respectively. Procedural success was 100% and high postprocedure percent stent expansion (MV 96 [93, 109]%, SB 88 [77, 100]%, carina MV 135 [99, 166]%, carina SB 116 [91, 130]%) was demonstrated by IVUS. At 9‐month angiographic follow‐up ( n = 28 patients), one MV in‐segment restenosis and one SB in‐stent restenosis were observed. SB in‐stent late lumen loss was 0.41 ± 0.27 mm. IVUS assessment revealed the absence of stent recoil; percent carinal neointimal hyperplasia (NIH) was 1.8 [0.0,11.2]% in MV and 15.0 [6.7,23.5]% in SB, with NIH volume obstruction of 2.0 [0.7,4.3]% in MV and 14.2 [7.5,29.6]% in SB. Conclusions Stenting of complex BL with the TBS+EES provides high acute success with sustained clinical, angiographic, and IVUS results at 9 months. These excellent results are likely due to the extent of stent expansion at the carina. © 2014 Wiley Periodicals, Inc.