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Semelhante a Jens Flensted Lassen MD, PH.D., FESC discusses bifurcation stenting techniques
Semelhante a Jens Flensted Lassen MD, PH.D., FESC discusses bifurcation stenting techniques (20)
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Jens Flensted Lassen MD, PH.D., FESC discusses bifurcation stenting techniques
- 1. Jens Flensted Lassen MD, PH.D., FESC. Clinical Director, Associated professor Cardiac Catheterization Laboratory Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen Copenhagen, Denmark Breakfast Meeting: Establising the New Standard: Definitive Treatment for Complex Bifurcation Lesions. (Sponsered by Tryton medical, Inc.) . TCT2016, October 30. 2016, Washington DC. USA Importance of Side Branch Ostial Scaffolding
- 2. Disclosure Statement of Financial Interest I, (Jens Flensted Lassen) DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation.
- 3. Disclosure Statement of Financial Interest ……. BUT !!! I, (Jens Flensted Lassen) am a Board member and one of the Directors of the European Bifurcation Club (EBC) and my view on bifurcation stenting is heavily influenced by the thoughts and consensus statements of EBC.
- 4. STRESS-trial (1994) and Benestent (1994) ≈ Tryton Pivotal (2015)
- 8. • Workhorse DES: Optimized for Straight Lesions Poorly Suited to of Bifurcation Lesions • Wide Variety of Techniques Required Poorly Characterized Inconsistently Performed: Crush, Culotte, reverse Culotte, internal crush, reverse crush, T, provisional T, TAP, TAP and protusion, Y, extended Y, V, SKS, double barrel, Helqvist, sleeve, modified crush, Buchbinder, mini crush, reverse mini crush, short back and sides, DK crush, flower, etc., etc. Treating Bifurcation Lesions Why is it difficult to evaluate?
- 9. Crush Technique Courtesy of J. Ormiston Not all 2 stent techniques are the same Stents not designed for bifurcation Triple layer Limited scaffolding
- 10. Nordic II: Localization of In-Stent Restenosis at 8-Month Follow-up
- 11. Angiographic restenosis* at 8 months Nordic-Baltic Bifurcation Study IV Binary restenosis ≥ 50% diameter stenosis QCA by dedicated bifurcation analysis. Medis QAngioXA 7.3 1.3% 0.7% 1.3%1.3% n = 153 n = 154 Provisional SB stent technique Two-stent technique (Culotte/T) niels.holm@clin.au.dk 5.2% 20.3%
- 12. What is the ideal technique or the ideal device for coronary bifurcation treatment and does one strategy or device fit all?
- 13. Tryton Stent Designed for all coronary bifurcations Ostial Scaffolding >3.5 mm >4.5 mm Expansion range No Angle Limitations
- 14. Summary & Conclusion • Tryton stent was designed to accommodate variations in vessel caliber and angle while providing main vessel stent-like scaffolding to the ostium and side branch. • The in vitro results have been confirmed in daily clinical practice. • One technique may fit all bifurcations – if the side branch is large enough.