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How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting
Imaging-guided coronary bifurcation intervention has improved clinical outcomes due to the appropriate size selection of the devices and optimization of the procedure (sufficient stent expansion, reduction of stent malapposition, appropriate stent landing zone, and detection of vessel dissection). I...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9692107/ https://www.ncbi.nlm.nih.gov/pubmed/36440010 http://dx.doi.org/10.3389/fcvm.2022.1023834 |
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author | Murasato, Yoshinobu |
author_facet | Murasato, Yoshinobu |
author_sort | Murasato, Yoshinobu |
collection | PubMed |
description | Imaging-guided coronary bifurcation intervention has improved clinical outcomes due to the appropriate size selection of the devices and optimization of the procedure (sufficient stent expansion, reduction of stent malapposition, appropriate stent landing zone, and detection of vessel dissection). In particular, three-dimensional optical coherence tomography (3D OCT) facilitates clear visualization of stent configuration and guidewire position, which promotes optimal guidewire crossing to the side branch. Successive side branch dilation leads to wide ostial dilation with less strut malapposition. However, the link connection of the stent located on the bifurcated carina has been found to be an impediment to sufficient opening of the side branch, resulting in incomplete strut apposition. In such cases, the aggressive proximal optimization technique improves the jailing strut pattern, and 3D OCT navigates the guidewire crossing to the optimal cell that is most likely to be expanded sufficiently, which is not always a distal cell. In two-stent deployment, 3D OCT facilitates optimal guidewire crossing, which leads to less metallic carina, clustering, and overlapping. The present review describes a method of clear visualization and assessment with 3D OCT and discusses the efficacy of 3D OCT in coronary bifurcation stenting in clinical practice. |
format | Online Article Text |
id | pubmed-9692107 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96921072022-11-26 How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting Murasato, Yoshinobu Front Cardiovasc Med Cardiovascular Medicine Imaging-guided coronary bifurcation intervention has improved clinical outcomes due to the appropriate size selection of the devices and optimization of the procedure (sufficient stent expansion, reduction of stent malapposition, appropriate stent landing zone, and detection of vessel dissection). In particular, three-dimensional optical coherence tomography (3D OCT) facilitates clear visualization of stent configuration and guidewire position, which promotes optimal guidewire crossing to the side branch. Successive side branch dilation leads to wide ostial dilation with less strut malapposition. However, the link connection of the stent located on the bifurcated carina has been found to be an impediment to sufficient opening of the side branch, resulting in incomplete strut apposition. In such cases, the aggressive proximal optimization technique improves the jailing strut pattern, and 3D OCT navigates the guidewire crossing to the optimal cell that is most likely to be expanded sufficiently, which is not always a distal cell. In two-stent deployment, 3D OCT facilitates optimal guidewire crossing, which leads to less metallic carina, clustering, and overlapping. The present review describes a method of clear visualization and assessment with 3D OCT and discusses the efficacy of 3D OCT in coronary bifurcation stenting in clinical practice. Frontiers Media S.A. 2022-11-11 /pmc/articles/PMC9692107/ /pubmed/36440010 http://dx.doi.org/10.3389/fcvm.2022.1023834 Text en Copyright © 2022 Murasato. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Murasato, Yoshinobu How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting |
title | How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting |
title_full | How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting |
title_fullStr | How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting |
title_full_unstemmed | How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting |
title_short | How to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting |
title_sort | how to use three-dimensional optical coherence tomography effectively in coronary bifurcation stenting |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9692107/ https://www.ncbi.nlm.nih.gov/pubmed/36440010 http://dx.doi.org/10.3389/fcvm.2022.1023834 |
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