Translational research

DOI: 10.4244/EIJ-D-23-00063

Configuration of two-stent coronary bifurcation techniques in explanted beating hearts: the MOBBEM study

Stefano Cangemi1, MD; Francesco Burzotta1,2, MD, PhD; Francesco Bianchini1, MD; Amanda DeVos3, BS; Thomas Valenzuela3, PhD; Carlo Trani1,2, MD; Cristina Aurigemma2, MD, PhD; Enrico Romagnoli2, MD, PhD; Jens Flested Lassen4, MD, PhD; Goran Stankovic5, MD, PhD; Paul Anthony Iaizzo3, PhD


Background: In patients with complex coronary bifurcation lesions undergoing percutaneous coronary intervention (PCI), various 2-stent techniques might be utilised. The Visible Heart Laboratories (VHL) offer an experimental environment where PCI results can be assessed by multimodality imaging.

Aims: We aimed to assess the post-PCI stent configuration achieved by 2-stent techniques in the VHL and to evaluate the procedural factors associated with suboptimal results.

Methods: Bifurcation PCI with 2-stent techniques, performed by expert operators in the VHL on explanted beating swine hearts, was studied. The adopted bifurcation PCI strategy and the specific procedural steps applied in each procedure were classified according to Main, Across, Distal, Side (MADS)-2 and to their adherence to the European Bifurcation Club (EBC) recommendations. Microcomputed tomography (micro-CT) was used to assess the post-PCI stent configuration. The primary endpoint was “suboptimal stent implantation”, defined as a composite of stent underexpansion (<90%), side branch ostial area stenosis >50% and the gap between stents.

Results: A total of 82 PCI with bifurcation stenting were assessed, comprised of 29 crush, 25 culotte, 28 T/T and small protrusion (TAP) techniques. Suboptimal stent...

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Volume 19 Number 5
Aug 7, 2023
Volume 19 Number 5
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