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Bifurcation Stenting

Abstract

Recommended Article

Percutaneous coronary intervention for obstructive bifurcation lesions the 14th consensus document from the european bifurcation club Treatment of coronary bifurcation lesions: current knowledge and future perspectives The EBC TWO Study (European Bifurcation Coronary TWO): A Randomized Comparison of Provisional T-Stenting Versus a Systematic 2 Stent Culotte Strategy in Large Caliber True Bifurcations Tips of the dual-lumen microcatheter-facilitated reverse wire technique in percutaneous coronary interventions for markedly angulated bifurcated lesions Randomized study on simple versus complex stenting of coronary artery bifurcation lesions: the Nordic bifurcation study Randomized trial of simple versus complex drug-eluting stenting for bifurcation lesions: the British Bifurcation Coronary Study: old, new, and evolving strategies The Comparison of Clinical Outcomes After Drug-Eluting Balloon and Drug-Eluting Stent Use for Left Main Bifurcation In-Stent Restenosis Anatomical Attributes of Clinically Relevant Diagonal Branches in Patients with Left Anterior Descending Coronary Artery Bifurcation Lesions
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Original Research

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支持低内皮剪切力在动脉粥样硬化形成扮演重要角色的最新证据

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“Role of local coronary blood flow patterns and shear stress on the development of microvascular and epicardial endothelial dysfunction and coronary plaque”汇总了2018年实现在活体中采用心血管影像获取的动脉粥样硬化斑块的最新科研突破及并分析了血流、内皮剪切力在心外膜、微血管内皮功能异常和冠脉粥样硬化形成中扮演的角色


“Implications of the local hemodynamic forces on the formation and destabilization of neoatherosclerotic lesions”呈现了局部内皮剪切力在易损斑块形成中的最新证据。其试验设计采用OCT成像对36例新生动脉粥样硬化病变进行冠脉解剖结构重建，以支架置入即刻支架边界为基准模拟管腔表面，评估内皮剪切力（ESS）的高低与新生内膜负荷、新生动脉粥样硬化和新生内膜特征之间的关系后发现：

- 基线ESS与新生动脉粥样硬化负荷发病率及脂质动脉粥样硬化组织间呈负相关；

- 低ESS(<1 Pa)节段处更易形成巨噬细胞聚集（macrophages accumulation）、血栓和新生内膜不连续（neointima discontinuities ）；

- 而新生内膜破裂节段处ESS更高。


“Evolving insights into the role of local shear stress in late stent failure from neoatherosclerosis formation and plaque destabilization”为以上研究的Editorial,进一步梳理了因局部内皮剪切力的变化而导致的新生动脉粥样硬化和斑块不稳定性对晚期支架失败的影响机制。

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