Hemodynamic change in wall shear stress in patients with coronary bifurcation lesions treated by double kissing crush or single-stent technique

摘要

Background Fluid dynamic mechanisms attributed to coronary bifurcation lesions remain a subject of study.The present study aimed at investigating the hemodynamic change of wall shear stress (WSS) in patients with coronary bifurcation lesions treated by double kissing (DK) crush or one-stent with final kissing balloon inflation (FKBI).Methods Eighty-one patients with bifurcation lesions treated by stenting who had 3-D model reconstruction were studied.The bifurcation vessels were divided into main vessel (MV),main branch (MB),side branch (SB),and polygon of confluence (POC).MB and SB were classified by internal- and lateral-subsegments,respectively.Results The baseline magnitude of WSS in proximal MV,POC-MV,POC-MB,POC-SB and MB-internal segments increased significantly,compared to MB-lateral,SB-internal and SB-lateral.DK crush had the potential of uniformly reducing WSS,turbulent index and the WSS gradient.The WSS value at the POC-SB and SB in the one-stent group remained higher.The turbulent index and WSS gradient between the POC-SB minus the SB-lateral had equal predictive values for in-stent restenosis (ISR).Conclusion Fluid dynamic results favor the use of DK crush over the one-stent technique.