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

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。

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。

6-9 月期间进行冠脉造影复查。

临床随访持续到 12 个月。

结 果

58 59 6163

0

10

20

30

40

50

60

70

80

Classical DK

Patients

Lesions

P <0.001F

KB

I (%

)

P <0.01U

nsa

tisf

acto

ry

FK

BI

(%)

P <0.001R

este

nos

is (

%)

P =0.001M

AC

E (

%)

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。

致 谢

Double-Kissing Culotte Stenting Technique in Coronary

Bifurcation Disease

Hu, Tao

Department of Cardiovascular Medicine Xijing Hospital, the Fourth Military Medical

University

Percutaneous treatment of coronary

bifurcation disease remains challenging.

Optimal treatment with percutaneous

coronary intervention (PCI) for

bifurcation lesions has not yet been

achieved.

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.

FIRST KISSING

DOUBLE KISSING

FINAL RESULTS

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.

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.

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.

Results

58 59 6163

0

10

20

30

40

50

60

70

80

Classical DK

Patients

Lesions

P <0.001F

KB

I (%

)

P <0.01U

nsa

tisf

acto

ry

FK

BI

(%)

P <0.001R

este

nos

is (

%)

P =0.001M

AC

E (

%)

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.

THANKS