Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-031

The Importance of Performing Final kissing Balloon Dilation Before Final Proximal Optimization When Using Provisional Stenting Technique in Bifurcation Lesions. A Computational Fluid Dynamics Study.

By Hassan Ali Warda, Mai El Zayat, Hazem Mamdouh Warda, Osama Shoeib, Essam Wahba

Presenter

Hassan Ali Warda

Authors

Hassan Ali Warda1, Mai El Zayat2, Hazem Mamdouh Warda2, Osama Shoeib3, Essam Wahba2

Affiliation

Alhyatt Heart and Vascular Center, Egypt1, Alhyatt Cardiovascular center, Egypt2, Tanta University Hospital, Egypt3
View Study Report
TCTAP A-031
Bifurcation/Left Main Diseases and Intervention

The Importance of Performing Final kissing Balloon Dilation Before Final Proximal Optimization When Using Provisional Stenting Technique in Bifurcation Lesions. A Computational Fluid Dynamics Study.

Hassan Ali Warda1, Mai El Zayat2, Hazem Mamdouh Warda2, Osama Shoeib3, Essam Wahba2

Alhyatt Heart and Vascular Center, Egypt1, Alhyatt Cardiovascular center, Egypt2, Tanta University Hospital, Egypt3

Background

When treating coronary bifurcation lesions using provisional stenting, the importance of performing Final Kissing  Balloon Dilation (KBD) before performing final proximal optimization re-(POT) is a matter of debate. We assume that initial POT followed by single side branch dilatation (without KBD) may result in strut malapposition despite performing final POT.

Methods

Provisional stenting was performed using POT-SIDE-POT without KBD and used (CFD) to identify the local hemodynamic parameters and values of wall shear stress (WSS ) on the malapposed stent.

Results

Provisional stenting without final KBD despite re-(POT) affects local flow patterns and shear rate (Fig.1) and introduces areas of low WSS along the malapposed and shifted stent areas (Fig.2).

Conclusion

Strut malapposition in cases where a final KBD despite (re)-POT is not performed disrupts blood flow causing low wall shear stress regions and may explain the relative increase in the risk of developing restenosis as suggested by the present CFD study. 

Leave Comments