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Lessons from bench testing

EBC - ON DEMAND

European Bifurcation Club 2005, EBC 2005 – Bordeaux, France

STRATEGY ON BIFURCATION LESION TREATMENT

Lessons from bench testing

Author: John Ormiston, MD, Auckland, New Zealand

 

SUMMARY

  • There is no perfect solution to bifurcation stenting
  • Bench testing revealed that dilatation through the side of stent causes distortion best corrected by “kissing” balloon post-dilatation
  • If there are gaps after “T” stenting, it is because the stent is too distal
  • After “crush” bifurcation stenting, “kissing” improves bench and clinical outcomes
  • “Kissing” must be performed with balloons equal or larger diameter than deploying balloons
  • Mulitple layers of DES may impede endothialization and predispose to thrombosis
  • Bifurcation stenting with conventional post-dilatation pressures only minimally damages polymer
  • It is possible to severely damage polymer with extreme pressures and repeated post-dilatation
  • Risk of damage to polymer should not be an argument for inadequate post-dilatation
  • A permanent polymer covering the entire stent may not be necessary.

 

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