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Scanning Electron Microscopic Assessment of Stent Coating Integrity in Jailed Wire Technique for Bifurcation Treatment
Journal of Interventional Cardiology ( IF 1.6 ) Pub Date : 2021-05-24 , DOI: 10.1155/2021/2629393
Lijian Gao 1 , Ce Zhang 1 , Huanhuan Wang 1 , Yiqun Zhang 2 , Zhan Gao 1 , Bo Xu 1 , Jue Chen 1 , Jinqing Yuan 1 , Shubin Qiao 1 , Jilin Chen 1
Affiliation  

Objectives. To assess the impact of different guidewires on stent coating integrity in jailed wire technique (JWT) for bifurcation treatment. Background. JWT is commonly adopted to protect side branch in provisional one-stent strategy for coronary bifurcation lesions. However, this technique may cause defects in stent coatings. The degree of coating damage caused by different types of jailed wires remains unknown. Methods. A fluid model with a bifurcation was established to mimic the condition in vivo. One-stent strategy was performed with three types of guidewire (nonpolymer-jacketed wire, intermediate polymer-jacketed wire, and full polymer-jacketed wire) tested for JWT. Scanning electron microscopy (SEM) was used to evaluate stent coating integrity and wire structure. The degrees of coating defects were recorded as no, slight, moderate, and severe defects. Results. A total of 27 samples were tested. Analyses of SEM images showed a significant difference in the degree of coating damage among the three types of wire after the procedure of JWT (). Nonpolymer-jacketed wire could inevitably cause a severe defect in stent coatings, while full polymer-jacketed wire caused the least coating damages. Besides, there were varying degrees of coil deformation in nonpolymer-jacketed wires, while no surface damage or jacket shearing was observed in full polymer-jacketed wires. Conclusions. Although nonpolymer-jacketed wire has long been recommended for JWT, our bench-side study suggests that full polymer-jacketed wire may be a better choice. Further clinical studies are needed to confirm our findings.

中文翻译:

扫描电镜评估支架线技术分叉处理中支架涂层的完整性

目标。在分叉治疗的监狱线技术(JWT)中评估不同导线对支架涂层完整性的影响。背景。在冠状动脉分叉病变的临时单支架策略中,JWT通常用于保护侧支。但是,这种技术可能会导致支架涂层的缺陷。由不同类型的铁丝网造成的涂层损坏程度仍然未知。方法。建立具有分叉的流体模型以模拟体内状况。使用三种用于JWT的导丝(无夹层护套线,中夹层护套线和全夹层护套线)执行了一种支架策略。扫描电子显微镜(SEM)用于评估支架涂层的完整性和线结构。记录涂层缺陷的程度为无,轻微,中度和严重缺陷。结果。总共测试了27个样品。SEM图像分析表明,在JWT处理之后,三种类型的焊丝之间的涂层损坏程度存在显着差异()。用无聚合物夹套的金属丝不可避免地会导致支架涂层严重缺陷,而用全聚合物套夹的金属丝造成的涂层损坏最少。此外,在无聚合物夹套导线中,线圈变形程度不同,而在全聚合物夹套导线中未观察到表面损伤或护套剪切。结论。尽管长期以来,JWT一直推荐使用非聚合物夹套线材,但我们的台式研究表明,使用全聚合物夹套线材可能是更好的选择。需要进一步的临床研究以证实我们的发现。
更新日期:2021-05-24
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