- Email: [email protected]
Benefits of final proximal optimisation technique (POT) in provisional stenting
01 — Coronary heart disease
9
Purpose We aimed to investigate the impact of the average table height on the level of radiation delivered to cardiologists performing coronary interventions. Methods The population for analysis included all invasive coronary procedures performed in a single catheterization laboratory (cathlab) in our centre from March to June 2017. The primary endpoint was operator radiation exposure, as assessed using personal electronic dosimeters located on the operator’s left arm. Results In total, 225 invasive coronary procedures were analyzed. When the average table height was 1126 mm or more, the operators received a radiation dose that was, on average, 53% lower than when the table was lower than 1126 mm (P = 0.02). This reduction remained significant by multivariate analysis adjusted for the operator (P < 0.001). Conclusions Our study suggests that the position of the patient table at a height of 1126 mm or higher from the ground decreases the radiation exposure of the operator by 53%, regardless of the operator. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2018.10.011 079
Benefits of final proximal optimisation technique (POT) in provisional stenting F. Derimay 1,∗ , G. Rioufol 1 , G. Cellier 1 , G. Souteyrand 2 , G. Finet 1 Service de cardiologie, hôpital cardiologique Louis-Pradel, Bron 2 service de cardiologie, CHU Clermont-Ferrand, Clermont-Ferrand, France ∗ Corresponding author. Adresse e-mail : [email protected] (F. Derimay) 1
Aims Initial proximal optimisation technique (POT) in provisional stenting improves global malapposition, side-branch (SB) obstruction (SBO) and conservation of arterial circularity. The specific mechanical effects of a final POT sequence concluding the main provisional stenting techniques, on the other hand, are unknown. Methods SynergyTM stents were implanted on fractal coronary bifurcation bench models using the main provisional stenting techniques (n = 5 per group): kissing-balloon inflation (KBI), snuggle, and rePOT (initial POT + SB inflation + final POT). Final results were quantified on 2D and 3D OCT before and after final POT. Results Whichever the technique, final POT significantly decreased global malapposition (from 7.6 ± 5.3% to 2.2 ± 2.5%, P < 0.05) and proximal elliptic deformation (from 1.15 ± 0.07 to 1.09 ± 0.04, P < 0.05), without impact on SBO (from 11.5 ± 9.6% to 12.9 ± 10.6%, NS). However, final POT failed to completely correct the elliptic deformation induced by balloon juxtaposition during the KBI and snuggle techniques, with final elliptic ratios of 1.11 ± 0.03 and 1.11 ± 0.04 respectively, significantly higher than with the full rePOT sequence: 1.05 ± 0.02 (P < 0.05) (Fig. 1). Conclusions Like initial POT, final POT is mandatary whatever the provisional stenting technique used. However, final POT fails to completely correct all proximal elliptic deformation associated with ‘‘kissing-like’’ techniques, in contrast to results with the rePOT sequence.
Fig. 1 POT final Derimay F. Main final POT effects in three provisional stenting techniques (n = 15). * P < 0.05 vs. before final POT. Ellipticity ratio was measures at polygon of confluence entry. KBI: kissing-balloon inflation; POT: proximal optimization technique; SBO: side-branch obstruction. Disclosure of interest peting interest.
The authors declare that they have no com-
https://doi.org/10.1016/j.acvdsp.2018.10.012
Thursday, January 17th, 2019 110
Short-term effects of air pollution on coronary events. Importance of seasonal variations B. Vaudrey 1,∗ , M. Mielcarek 2 , E. Sauleau 2 , N. Meyer 2 , B. Marchandot 1 , M. Moitry 3 , P. Robellet 4 , T. Reeb 5 , L. Jesel 1,6 , P. Ohlmann 1 , Thomas Bourdrel 5 , O. Morel 1,6 1 CHU Strasbourg 2 Department of biostatistics, univesity of Strasbourg 3 Laboratoire d’épidémiologie, faculté de médecine, Strasbourg 4 ATMO Grand Est, Schiltigheim 5 Clinique Rhéna 6 UMR Inserm 1230 Regenerative Nanomedicine, university of Strasbourg, Strasbourg, France ∗ Corresponding author. Adresse e-mail : [email protected] (B. Vaudrey)
9
Purpose We aimed to investigate the impact of the average table height on the level of radiation delivered to cardiologists performing coronary interventions. Methods The population for analysis included all invasive coronary procedures performed in a single catheterization laboratory (cathlab) in our centre from March to June 2017. The primary endpoint was operator radiation exposure, as assessed using personal electronic dosimeters located on the operator’s left arm. Results In total, 225 invasive coronary procedures were analyzed. When the average table height was 1126 mm or more, the operators received a radiation dose that was, on average, 53% lower than when the table was lower than 1126 mm (P = 0.02). This reduction remained significant by multivariate analysis adjusted for the operator (P < 0.001). Conclusions Our study suggests that the position of the patient table at a height of 1126 mm or higher from the ground decreases the radiation exposure of the operator by 53%, regardless of the operator. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2018.10.011 079
Benefits of final proximal optimisation technique (POT) in provisional stenting F. Derimay 1,∗ , G. Rioufol 1 , G. Cellier 1 , G. Souteyrand 2 , G. Finet 1 Service de cardiologie, hôpital cardiologique Louis-Pradel, Bron 2 service de cardiologie, CHU Clermont-Ferrand, Clermont-Ferrand, France ∗ Corresponding author. Adresse e-mail : [email protected] (F. Derimay) 1
Aims Initial proximal optimisation technique (POT) in provisional stenting improves global malapposition, side-branch (SB) obstruction (SBO) and conservation of arterial circularity. The specific mechanical effects of a final POT sequence concluding the main provisional stenting techniques, on the other hand, are unknown. Methods SynergyTM stents were implanted on fractal coronary bifurcation bench models using the main provisional stenting techniques (n = 5 per group): kissing-balloon inflation (KBI), snuggle, and rePOT (initial POT + SB inflation + final POT). Final results were quantified on 2D and 3D OCT before and after final POT. Results Whichever the technique, final POT significantly decreased global malapposition (from 7.6 ± 5.3% to 2.2 ± 2.5%, P < 0.05) and proximal elliptic deformation (from 1.15 ± 0.07 to 1.09 ± 0.04, P < 0.05), without impact on SBO (from 11.5 ± 9.6% to 12.9 ± 10.6%, NS). However, final POT failed to completely correct the elliptic deformation induced by balloon juxtaposition during the KBI and snuggle techniques, with final elliptic ratios of 1.11 ± 0.03 and 1.11 ± 0.04 respectively, significantly higher than with the full rePOT sequence: 1.05 ± 0.02 (P < 0.05) (Fig. 1). Conclusions Like initial POT, final POT is mandatary whatever the provisional stenting technique used. However, final POT fails to completely correct all proximal elliptic deformation associated with ‘‘kissing-like’’ techniques, in contrast to results with the rePOT sequence.
Fig. 1 POT final Derimay F. Main final POT effects in three provisional stenting techniques (n = 15). * P < 0.05 vs. before final POT. Ellipticity ratio was measures at polygon of confluence entry. KBI: kissing-balloon inflation; POT: proximal optimization technique; SBO: side-branch obstruction. Disclosure of interest peting interest.
The authors declare that they have no com-
https://doi.org/10.1016/j.acvdsp.2018.10.012
Thursday, January 17th, 2019 110
Short-term effects of air pollution on coronary events. Importance of seasonal variations B. Vaudrey 1,∗ , M. Mielcarek 2 , E. Sauleau 2 , N. Meyer 2 , B. Marchandot 1 , M. Moitry 3 , P. Robellet 4 , T. Reeb 5 , L. Jesel 1,6 , P. Ohlmann 1 , Thomas Bourdrel 5 , O. Morel 1,6 1 CHU Strasbourg 2 Department of biostatistics, univesity of Strasbourg 3 Laboratoire d’épidémiologie, faculté de médecine, Strasbourg 4 ATMO Grand Est, Schiltigheim 5 Clinique Rhéna 6 UMR Inserm 1230 Regenerative Nanomedicine, university of Strasbourg, Strasbourg, France ∗ Corresponding author. Adresse e-mail : [email protected] (B. Vaudrey)