The POT-PUFF sign: an angiographic mark of stent malapposition during proximal optimisation

DOI: 10.4244/EIJ-D-22-00861

Farhang Aminfar
Farhang Aminfar1, MD; Vladimir Rubimbura2, MD; Luc Maillard3, MD, PhD; Stéphane Noble4, MD; Grégoire Rangé5, MD; Loic Belle6, MD; Francois Derimay7, MD; Anne Bellemain-Appaix8, MD; Alexis Al Karaky9, MD, PhD; Jean Francois Morelle10, MD; Georgios Sideris11, MD, PhD; Pascal Motreff12, MD, PhD; Olivier Muller1, MD, PhD; Julien Adjedj13, MD, PhD
1. Department of Cardiology, CHUV, Lausanne University Hospital, Lausanne, Switzerland; 2. Interventional Cardiology Unit, Morges Hospital, Morges, Switzerland; 3. Department of Cardiology, GCS ES Axium Rambot, Aix-en-Provence, France; 4. Department of Cardiology, Geneva University Hospital, Geneva, Switzerland; 5. Department of Cardiology, Chartres Hospital, Chartres, France; 6. Department of Cardiology, Annecy Hospital, Annecy, France; 7. Invasive Cardiology Department, Cardiovascular Louis Pradel Hospital, Hospices Civils de Lyon and Claude Bernard University, Lyon, France; 8. Department of Cardiology, Centre Hôpitalier d’Antibes Juan-les-Pins, Antibes, France; 9. Department of Cardiology, Fréjus Saint-Raphael Hospital, Fréjus, France; 10. Department of Cardiology, Hôpital Privé Saint-Martin, Caen, France; 11. Department of Cardiology, University Hospital of Clermont Ferrand, Clermont Ferrand, France; 12. Department of Cardiology, Hôpital Lariboisière, Paris, France; 13. Department of Cardiology, Institut Arnault Tzanck, Saint-Laurent-du-Var, France
Coronary bifurcation lesions are frequently encountered in everyday percutaneous coronary intervention (PCI)12 and are associated with a high risk of malapposition and adverse clinical events3. To reduce malapposition in the mother branch, the proximal optimisation technique (POT) remains a standard to improve bifurcation PCI4. To detect malapposition in the mother branch, we used an angiographic sign based on contrast medium progression through the inflated POT balloon to evaluate coronary opacification and flow, named the POT-PUFF sign. We hypothesised that the progression of contrast medium (PUFF) through the inflated POT balloon (defined as a positive POT-PUFF sign), could better detect stent ...

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Coronary interventionsBifurcation lesions
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