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DK Culotte 支架技术在冠脉分叉病变中的应用

DK Culotte 支架技术在冠脉分叉病变中的应用. 胡 涛 第四军医大学西京医院心内科. 冠脉介入手术中分叉病变的处理仍然没有理想的方案。 目前已成为全球冠心病介入治疗学的研究热点。. 在双支架植入术式中 , Culotte 技术得到了广泛的应用，但仍然有其局限性。 因此我们设计了改良的两次球囊对吻 (DK) 方法以期能获得更佳的 Culotte 技术效果 。. FIRST KISSING. DOUBLE KISSING. FINAL RESULTS.

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DK Culotte 支架技术在冠脉分叉病变中的应用

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  1. DK Culotte 支架技术在冠脉分叉病变中的应用 胡 涛 第四军医大学西京医院心内科

  2. 冠脉介入手术中分叉病变的处理仍然没有理想的方案。冠脉介入手术中分叉病变的处理仍然没有理想的方案。 • 目前已成为全球冠心病介入治疗学的研究热点。

  3. 在双支架植入术式中, Culotte 技术得到了广泛的应用，但仍然有其局限性。 • 因此我们设计了改良的两次球囊对吻 (DK) 方法以期能获得更佳的Culotte 技术效果 。

  4. FIRST KISSING

  5. DOUBLEKISSING

  6. FINAL RESULTS

  7. 为了验证此改良方法的效果，我们设计了前瞻随机对照试验，对DK和经典 Culotte 技术进行了最终球囊对吻率 (FKBI)以及长期临床随访结果的比较。

  8. 方法 • 真性分叉病变患者（麦迪兰分型1，1，1）随机分为DK或经典 Culotte 组植入药物洗脱支架。

  9. 6-9月期间进行冠脉造影复查。 • 临床随访持续到12个月。

  10. 结 果

  11. P <0.001 FKBI (%)

  12. P <0.01 Unsatisfactory FKBI (%)

  13. P <0.001 Restenosis (%)

  14. P =0.001 MACE (%)

  15. 结论 • DK Culotte 技术提高了最终球囊对吻率，冠脉造影复查再狭窄率低于经典Culotte 技术。 • 长期临床随访结果显示DK Culotte 技术组有着更佳的临床结果。

  16. 致 谢

  17. Double-Kissing Culotte Stenting Technique in CoronaryBifurcation Disease Hu, Tao Department of Cardiovascular Medicine Xijing Hospital, the Fourth Military Medical University

  18. Percutaneous treatment of coronary bifurcation disease remains challenging. • Optimal treatment with percutaneous coronary intervention (PCI) for bifurcation lesions has not yet been achieved.

  19. In patient subsets in which a two-stent strategy is necessary, the culotte technique is a widely used method. However, this technique has its own limitations. • We therefore developed a double kissing (DK) balloon method to optimize the final result of culotte stenting.

  20. FIRST KISSING

  21. DOUBLEKISSING

  22. FINAL RESULTS

  23. To study this technique, and to compare it with the classical culotte technique, we performed a prospective, randomized trial aimed at determining the differences in the rates of final kissing balloon inflation (FKBI) and long-term clinical outcomes at our institution.

  24. Methods • We prospectively enrolled patients undergoing PCI of a true coronary bifurcation lesion with a Medina classification of (1, 1, 1) with drug-eluting stents in our institution. • Patients were randomly assigned to undergo treatment using either the classical Culotte stenting or the DK Culotte stenting technique.

  25. Angiographic follow-up was scheduled between 6 and 9months. Clinical follow-up was available up to 12 months. • All patients underwent follow-up by telephone or clinic review.

  26. Results

  27. P <0.001 FKBI (%)

  28. P <0.01 Unsatisfactory FKBI (%)

  29. P <0.001 Restenosis (%)

  30. P =0.001 MACE (%)

  31. Conclusion • The DK Culotte stenting technique is associated with high procedural success by optimizing the FKBI rates and by allowing a complete stent expansion at the side branch ostium and a relatively low risk of angiographic restenosis. • The improved clinical outcomes were sustained even at a 12 month follow-up period.

  32. THANKS

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