This work compared the safety and efficacy of the culotte technique versus the use of self-expanding Biolimus A9 (AXXESS) eluting stent evaluating the healing of the vessel by OCT besides quantitative angiography and clinical events. In one, group (n = 20) bifurcated stent system AXXESS plus everolimus-eluting stents in the main distal branch and side branch and the other group (another 20 patients) the culotte technique plus everolimus eluting stent was used. It ended with kissing balloon using non-compliant balloons in all cases. No significant difference in miointimal coverage of struts evaluated by OCT at 9 months was observed.

In-the culotte group a delay in the miointimal coverage over the proximal segment of the main vessel related to the overlap of the stents was observed. In the AXXESS group, the lumen of proximal main vessel was significantly augmented probably related to the most anatomical sized due to the taper of the self-expanding device. 

Christophe Dubois
2014-05-20

Title: Complex coronary bifurcation lesions – Randomised comparison of a strategy using a dedicated self-expanding biolimus A9-eluting stent versus a culotte strategy using everolimus-eluting stents: primary results of the multicenter COBRA trial