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Side branch healing patterns of the Tryton dedicated bifurcation stent: a 1-year optical coherence tomography follow-up study

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Abstract

The bare-metal Tryton Side Branch (SB) Stent™ (Tryton Medical, Durham, NC, USA) is used with a drug-eluting stent (DES) in the main branch (MB) to treat bifurcation lesions. It is argued that a drug-eluting Tryton-version is needed to improve clinical outcomes, although previous registries have shown good clinical results. More insights in neo-intimal hyperplasia (NIH) growth patterns of the Tryton treatment strategy are needed to decide if and where to drug-coat the stent. Ten patients returned for follow-up angiography (mean follow-up time 393 ± 103 days) and optical coherence tomography (OCT) pullbacks from the MB were obtained in all patients and from the SB in six patients. A per-strut analysis showed an uncovered strut rate of 0.7 % and an incompletely-apposed strut rate of 0.8 %. Most incompletely-apposed struts were found at the bifurcation region, in the luminal half facing towards the SB. Mean NIH thickness in the proximal MB, distal MB and SB were 0.14 ± 0.11, 0.19 ± 0.11, and 0.34 ± 0.19 mm, respectively, with a variety of growth patterns observed in the SB. We found good vascular healing of the DES in the MB, while healing was less favourably in the SB part. Furthermore, we observed a variety of NIH growth patterns in this SB part and more studies are needed to investigate the relation between growth patterns and clinical outcomes.

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Conflict of interest

Maik Grundeken and Joanna Wykrzykowska receive consultancy fees from Tryton Medical. None of the other authors declared any relevant conflict of interest.

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Authors and Affiliations

  1. Department of Cardiology, The Heart Center, Academic Medical Center, University of Amsterdam, B2-127, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Maik J. Grundeken, Robin P. Kraak, P. Woudstra, Ton G. van Leeuwen, Karel T. Koch, Jan G. Tijssen, Robbert J. de Winter & Joanna J. Wykrzykowska

  2. The Thorax Center, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands

    Hector M. Garcia-Garcia

  3. Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Daniel M. de Bruin

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  1. Maik J. Grundeken
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  2. Hector M. Garcia-Garcia
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  10. Joanna J. Wykrzykowska
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Correspondence to Joanna J. Wykrzykowska.

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Grundeken, M.J., Garcia-Garcia, H.M., Kraak, R.P. et al. Side branch healing patterns of the Tryton dedicated bifurcation stent: a 1-year optical coherence tomography follow-up study. Int J Cardiovasc Imaging 30, 1445–1456 (2014). https://doi.org/10.1007/s10554-014-0504-y

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  • DOI: https://doi.org/10.1007/s10554-014-0504-y

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