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The presence of a coronary bifurcation complicates percutaneous revascularization. Bifurcation stenting needs to take into account the difference of diameter between proximal and distal vessels and the necessity to limit the side branch obstruction. Provisional stenting techniques with balloon juxtaposition as Kissing Balloon Inflation (KBI) fail to demonstrate a clinical benefits. This is probably explain by the detrimental effect during these technics on the proximal segment with an arterial overstretch. A new sequential technique, named rePOT, demonstrated experimentally a mechanical superiority compared to juxtaposition balloon techniques included KBI. RePOT associates an initial proximal optimizing technique (POT), a side branch inflation and a final POT.
A first clinical study (n=106 patients) confirmed these excellent mechanical results with serial OCT analysis and demonstrated an excellent short term safety. Since 2017, rePOT is recommended in Europe in clinical practice.
This large registry is dedicated to confirm the clinical benefits at long term after bifurcation revascularization with rePOT technique before a large randomise trial.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Provisional stenting with rePOT technique | Other | All revascularizations have to be performed with complete rePOT technique: initial POT + side branch inflation + final POT. Compliant or semi compliant balloon have to be preferred to inflations. The POT balloon positioning have to be precise as obtain the loose of the parallelism just at the carina cut plan. The rest of the medication or procedure characteristics stay at the discretion of the operator. The follow-up will be clinic every years. |
| Measure | Description | Time Frame |
|---|---|---|
| Long-term clinical benefits after revascularization of coronary bifurcations by the technique of provisional stenting rePOT. | Number of deaths | At 12 months |
| Long-term clinical benefits after revascularization of coronary bifurcations by the technique of provisional stenting rePOT. | Number of myocardial infections | At 12 months |
| Long-term clinical benefits after revascularization of coronary bifurcations by the technique of provisional stenting rePOT. | Number of stent thrombosis | At 12 months |
| Long-term clinical benefits after revascularization of coronary bifurcations by the technique of provisional stenting rePOT. | Number of target lesion revascularization | At 12 months |
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Inclusion Criteria:
Exclusion Criteria:
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All patient with stable coronary lesion interesting a bifurcation with indication of revascularization (angiographique or functional) by provisional stenting technique can be included.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Département de cardiologie Clinique Axium | Aix-en-Provence | 13090 | France | |||
| Fédération de cardiologie médicale - Hôpital Cardiologique Louis Pradel - Hospices civils de Lyon |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38048882 | Derived | Derimay F, Aminian A, Lattuca B, Souteyrand G, Maillard L, Alvain S, Cayla G, Motreff P, Bochaton T, Hayek A, Rioufol G, Finet G. One year results of coronary bifurcation revascularization with the re-POT provisional sequential technique. The CABRIOLET registry. Int J Cardiol. 2024 Feb 15;397:131632. doi: 10.1016/j.ijcard.2023.131632. Epub 2023 Dec 3. |
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| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| Bron |
| 69500 |
| France |
| Département de cardiologie Hôpital Gabriel Montpied CHU de Clermont Ferrand | Clermont-Ferrand | 63003 | France |
| Département de cardiologie CHU de Nimes | Nîmes | 30029 | France |