Feasibility and Short-Term Outcomes of Bioadaptor in Bifurcation Intervention Using Culotte Technique: Intravascular Ultrasound Analysis From a Single-Center Experience

Feasibility and Short-Term Outcomes of Bioadaptor in Bifurcation Intervention Using Culotte Technique: Intravascular Ultrasound Analysis From a Single-Center Experience | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Feasibility and Short-Term Outcomes of Bioadaptor in Bifurcation Intervention Using Culotte Technique: Intravascular Ultrasound Analysis From a Single-Center Experience Van Hoang, Tra Giang Tran, Ngoc Dung Tran, Dang Duong Nguyen, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9127530/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract BACKGROUND The DynamX Bioadaptor is a novel coronary implant with three helical strands that unlock and separate to provide dynamic vessel support restoring natural vessel function. Evidence in complex bifurcation lesions requiring planned two-stent strategies is limited. This analysis evaluated the feasibility and short-term outcomes of culotte bioadaptor implantation using intravascular ultrasound. METHODS Thirteen consecutive patients underwent bifurcation percutaneous coronary intervention using culotte technique with DynamX Bioadaptor between February and October 2025. All procedures followed a standardized culotte protocol with lesion preparation, POT, rewiring, and final kissing balloon inflation, with intravascular ultrasound used to assess bioadaptor expansion, apposition, and structural integrity. RESULTS Technical and procedural success was achieved in all patients (100%), with successful rewiring through bioadaptor struts in all attempts (26/26, 100%). Intravascular ultrasound demonstrated satisfactory expansion: main branch ostial expansion 94.9 ± 10.6%, side branch ostial expansion 90.2 ± 17.5%, proximal expansion ratio 0.95 ± 0.16. No strut fractures or malapposition occurred. CONCLUSIONS This first systematic evaluation demonstrates that bioadaptor implantation is highly feasible for culotte bifurcation stenting, achieving complete rewiring success and favorable acute intravascular ultrasound outcomes without compromising deliverability or structural integrity. bifurcation PCI coronary bioadaptor culotte technique DynamX intravascular ultrasound two-stent strategy Figures Figure 1 Figure 2 Figure 3 BACKGROUND Coronary bifurcation lesions account for approximately 15% to 20% of all percutaneous coronary interventions (PCI) and remain among the most technically challenging lesion subsets.¹ Despite advances in stent platforms and procedural techniques, bifurcation PCI continues to be associated with higher rates of procedural complications, restenosis, and stent thrombosis compared with non-bifurcation lesions.²˒³ Although a provisional single-stent strategy is preferred for most bifurcation lesions, two-stent techniques are required in approximately 20% to 30% of true bifurcations, particularly when the side branch is large, diffusely diseased, or supplies substantial myocardium.⁴˒⁵ Among two-stent approaches, the culotte technique provides comprehensive carina and side-branch ostial coverage with favorable outcomes when combined with proximal optimization technique (POT) and final kissing balloon inflation (KBI).⁶˒⁷ Successful culotte stenting requires specific stent platform characteristics. 8 , 9 These include thin strut thickness (< 80 µm) to minimize metal burden and flow disturbance, 10 adequate flexibility for navigating tortuous anatomy, 11 reliable rewirability through stent struts to enable distal cell crossing, 12,13 sufficient radial strength to resist recoil during high-pressure inflations, 14 and broad expansion capacity to accommodate vessel size mismatch without strut fracture. 15 The DynamX Bioadaptor (Elixir Medical Corporation, Milpitas, California) is a novel coronary implant designed to provide acute drug-eluting stent–like performance while restoring long term vessel physiology.¹⁶˒¹⁷ The device consists of three 71-µm cobalt-chromium helical strands interconnected by bioresorbable polymer-coated uncaging elements that degrade over approximately six months, enabling strands to unlock, separate and adapt to vessel motion. Clinical evidence demonstrates favorable outcomes. The BIOADAPTOR randomized controlled trial demonstrated non-inferiority to contemporary zotarolimus-eluting stents at 12 months, with superior imaging endpoints including reduced late lumen loss and restoration of cyclic pulsatility. 18 At 2-year follow-up, the trial demonstrated a statistically significant 65% reduction in target lesion failure (1.9% vs 5.5%, p = 0.046). 19 The INFINITY-SWEDEHEART trial subsequently confirmed these findings, demonstrating 48% reduction in target lesion failure (hazard ratio: 0.52, 95% confidence interval: 0.29–0.93, p = 0.027) in the landmark analysis from 6 months through 2 years. 20 The culotte technique requires sequential rewiring and creates double metal layers proximally, providing a large mechanical stresses on the implant. The bioadaptor mechanism of action may offer long term advantages in bifurcations which are associated with adverse shear stresses that promote neoatherosclerosis and late stent thrombosis.²¹˒²² Preliminary evidence supporting this approach was reported in the ADAPT-CULOTTE study, describing double bioadaptors in culotte configuration,²³ and the present analysis further evaluated the technical feasibility, expansion characteristics, and acute intravascular ultrasound outcomes of the bioadaptor in planned culotte bifurcation PCI. Despite these results, the performance of the bioadaptor in complex bifurcation PCI using two-stent strategies remains undefined. This study reports the first systematic evaluation of bioadaptor feasibility in culotte bifurcation PCI using comprehensive intravascular ultrasound analysis. METHODS Between February 2025 and October 2025, we prospectively enrolled 13 consecutive patients undergoing bifurcation PCI using the culotte technique with DynamX Bioadaptor at the Department of Interventional Cardiology, Hanoi Heart Hospital. All patients provided written informed consent prior to enrollment. The institutional ethics committee approved the study protocol, which was conducted in accordance with the Declaration of Helsinki. Study Population Inclusion criteria comprised symptomatic coronary artery disease with established indication for revascularization, de novo true bifurcation lesion classified as Medina 1,1,1; 1,0,1; or 0,1,1 morphology, side branch reference diameter ≥ 2.5 mm by visual estimation, side branch lesion length > 5 mm or presence of ostial disease, and absence of significant size mismatch between proximal main vessel and side branch. Exclusion criteria included cardiogenic shock, severe calcification requiring rotational atherectomy, and contraindication to dual antiplatelet therapy. Procedural Technique All procedures were performed via transradial or transfemoral access using 6-F or 7-F guide catheters. Culotte stenting followed a standardized protocol: (1) dual-wire lesion preparation with balloon predilatation and IVUS before or immediately after predilatation; (2) first stent deployment in the more angulated branch using a bioadaptor sized 1:1 to the distal reference diameter, protruding 2–3 mm into the proximal main vessel; (3) first proximal optimization technique (POT); (4) rewiring through stent struts with distal cell crossing and strut dilation using a 1.5–2.0 mm balloon; (5) second stent deployment in the main vessel; (6) second POT; (7) side-branch rewiring; (8) final kissing balloon inflation with two noncompliant balloons sized 1:1; (9) final POT to restore circular geometry; and (10) final IVUS assessment of all segments. Intravascular Ultrasound Protocol IVUS was performed using the AVVIGO Guidance System (Boston Scientific, Maple Grove, Minnesota) with automated 0.5-mm/s pullback. Quantitative IVUS analysis assessed minimal lumen area, stent area and expansion, stent apposition assessment with malapposition defined as > 200 µm separation between strut and vessel wall, assessment of strut layers in the proximal overlapping segment, coverage of the carina and side branch ostium, and evaluation for edge dissection or tissue prolapse. Qualitative analysis evaluated helical bioadaptor visibility, strut distribution, and structural abnormalities, including fracture or deformation. Study Endpoints The primary endpoint was technical success, defined as successful deployment of both bioadaptor stents with < 30% residual stenosis by visual assessment and TIMI flow grade 3 in both branches. Secondary endpoints included procedural success (technical success without in-hospital major adverse cardiac events [death, myocardial infarction, or urgent target vessel revascularization]), rewiring success rate through stent struts, final KBI success rate, IVUS-defined stent expansion and apposition, procedural complications, fluoroscopy time, and contrast volume. Statistical Analysis Continuous variables are expressed as mean ± SD or median (interquartile range) depending on distribution. Categorical variables are presented as frequencies and percentages. Given the exploratory nature and limited sample size, formal statistical hypothesis testing was not performed. RESULTS Baseline Characteristics Thirteen patients (mean age 60.3 ± 9.8 years; 85% male) were enrolled. Mean body mass index was 22.4 ± 3.0 kg/m². Clinical presentation comprised chronic coronary syndrome in 8 patients (62%), non–ST-segment elevation myocardial infarction in 3 patients (23%), and unstable angina in 1 patient (8%). Cardiovascular risk factors included current or former smoking in 9 patients (70%), diabetes mellitus in 5 patients (38.5%), and hypertension in 6 patients (46.2%). Mean estimated glomerular filtration rate was 79.2 ± 19.1 mL/min/1.73 m², mean low-density lipoprotein cholesterol was 2.57 ± 0.71 mmol/L, and mean left ventricular ejection fraction was 59.3 ± 15.4%. Baseline characteristics are summarized in Table 1 . Table 1 Baseline patient characteristics Variable Value (N = 13) Age, years 60.3 ± 9.8 Male sex 11 (84.6%) Body mass index, kg/m² 22.36 ± 3.02 Current or former smoking 9 (69.2%) Diabetes mellitus 5 (38.5%) Hypertension 6 (46.2%) Chronic coronary syndrome 8 (61.5%) NSTEMI 3 (23.1%) Unstable angina 1 (7.7%) eGFR, mL/min/1.73 m² 79.2 ± 19.1 LDL cholesterol, mmol/L 2.57 ± 0.71 Left ventricular ejection fraction, % 59.3 ± 15.4 Target bifurcation lesions were distributed in the left anterior descending/diagonal bifurcation in 9 cases (69%), left circumflex/obtuse marginal bifurcation in 3 cases (23%), and posterior descending artery–posterolateral ventricular branch in 1 case (8%). According to Medina classification, lesion distribution comprised 1,1,1 morphology in 12 cases (92.3%) and 0,1,1 morphology in 1 case (7.7%) as summarized in Table 2 . Mean bifurcation angle measured 64° ± 28°. Table 2 Lesion characteristics Variable Value Culprit vessel LAD–Diagonal 9 (69.2%) LCx–Obtuse marginal 3 (23.1%) PDA–PLV 1 (7.7%) Bifurcation type Medina 1,1,1 11 (84.6%) Medina 0,1,1 1 (7.7%) Medina 1,0,1 0 (0%) Procedural Outcomes Technical success was achieved in all 13 patients (100%). All bioadaptor stents were successfully delivered to intended positions, deployed, and adequately expanded according to IVUS criteria. The helical architecture did not create deliverability challenges or impede navigation through guide catheters or tortuous segments in any case. Rewiring through deployed stent struts was accomplished successfully in all cases for both initial (13 of 13, 100%) and subsequent (13 of 13, 100%) rewiring maneuvers. Mean time required for initial rewiring was 39.2 ± 19.0 seconds (range 15–75 seconds), whereas subsequent rewiring required 206.9 ± 162.4 seconds (range 45–600 seconds). Distal cell crossing, the preferred rewiring position, was achieved as intended in all cases without need to accept proximal cell positioning as a compromise. The helical structure with uncaging elements created a cell pattern that operators noted facilitated guidewire crossing. Final KBI was performed successfully in all cases (13 of 13, 100%), with complete simultaneous balloon expansion without residual waist observed in all procedures. POT was systematically executed at 3 time points in all cases. Mean procedure time was 55.2 ± 20.7 minutes, mean fluoroscopy time was 38.4 ± 17.6 minutes, and mean contrast volume was 218.0 ± 54.9 mL. Procedural outcomes are detailed in Tables 3 – 5 . Table 3 Procedural characteristics – Devices and technique (patient-level) Patient No. Main vessel pre-dilatation Side branch pre-dilatation Main vessel stent (mm) Side branch stent (mm) 1 Semi-compliant 2.0, 18 atm Semi-compliant 2.0, 18 atm 2.5 × 28 2.5 × 33 2 Semi-compliant 2.5, 18 atm Semi-compliant 2.5, 18 atm 3.5 × 28 3.5 × 23 3 Non-slip element 3.0, 24 atm Non-slip element 3.0, 24 atm 3.5 × 28 3.0 × 28 4 Not performed Not performed 3.5 × 28 3.0 × 18 5 Non-slip element 3.0, 20 atm Not performed 3.0 × 32 3.0 × 18 6 Scoring 2.0, 24 atm Not performed 2.75 × 23 2.5 × 18 7 Cutting 2.75, 20 atm Semi-compliant 2.5, 14 atm 3.5 × 23 3.5 × 18 8 Scoring 2.75, 16 atm Scoring 2.75, 14 atm 3.0 × 38 3.0 × 32 9 Non-compliant 3.5, 14 atm + Cutting 2.75, 14 atm Scoring 2.0, 24 atm 3.5 × 23 3.0 × 23 10 Scoring 3.0, 24 atm Scoring 3.0, 24 atm 3.5 × 23 3.5 × 32 11 Cutting 2.5, 12 atm Semi-compliant 2.0, 20 atm 3.0 × 28 2.75 × 23 12 Cutting 2.75, 18 atm Semi-compliant 2.0, 16 atm 3.5 × 38 3.5 × 18 13 Not performed Semi-compliant 2.0, 14 atm 3.0 × 38 3.0 × 28 Table 4 Procedural characteristics – Optimization (patient-level) Patient No. Main vessel post-dilatation (mm, atm) Side branch post-dilatation (mm, atm) Final kissing (MV diameter, atm) Final kissing (SB diameter, atm) POT (mm, atm) 1 2.75, 24 2.75, 24 2.5, 10 2.5, 10 3.0, 18 2 3.5, 24 3.25, 20 3.5, 14 3.25, 18 4.0, 16 3 3.5, 24 3.5, 20 3.25, 14 3.0, 14 4.0, 12 4 3.5, 20 3.5, 20 3.25, 16 3.25, 12 4.0, 18 5 3.25, 24 3.0, 24 3.25, 12 3.0, 12 4.0, 12 6 3.25, 24 2.5, 24 2.5, 12 2.5, 12 3.25, 16 7 3.5, 24 3.5, 24 3.25, 16 3.25, 14 4.0, 16 8 3.5, 20 3.5, 14 2.75, 16 2.75, 18 3.5, 18 9 3.5, 12 2.75, 20 3.25, 12 2.75, 12 4.0, 8 10 3.25, 24 3.25, 24 3.25, 14 3.25, 14 4.0, 14 11 2.75, 20 2.75, 18 2.5, 16 2.5, 16 3.25, 22 12 3.5, 24 3.5, 22 3.25, 16 3.0, 16 4.0, 22 13 3.5, 24 3.0, 24 2.75, 16 2.75, 12 4.0, 8 MV – Main Vessel, SB- Side Branch Table 5 Procedural metrics (overall) Variable Value (N = 13) Total rewiring time, s 246.2 ± 171.8 Contrast volume, mL 218.0 ± 54.9 Radiation dose, mGy 1288.7 ± 666.8 Fluoroscopy time, min 38.36 ± 17.56 IVUS Analysis Comprehensive IVUS imaging with complete quantitative analysis was successfully performed in all 13 patients. In the main branch, mean reference area measured 7.21 ± 1.77 mm² (range 4.65–9.75), distal stent area measured 7.30 ± 1.88 mm² (range 4.19–9.49), and overall expansion was 90.9 ± 13.6% (range 71.3-123.2). At the main branch ostium, expected ostial area measured 7.25 ± 1.66 mm² (range 4.90–9.62), achieved ostial stent area measured 6.83 ± 1.58 mm² (range 4.57–8.97), and ostial expansion was 94.9 ± 10.6% of expected (range 81.2-118.6). In the side branch, mean reference area measured 5.94 ± 1.82 mm² (range 3.50–9.16), distal stent area measured 6.18 ± 1.55 mm² (range 3.86–8.82), and overall expansion was 94.5 ± 10.5% (range 74.6-114.8). At the side branch ostium, expected ostial area measured 6.69 ± 1.35 mm² (range 4.90–8.29), achieved ostial stent area measured 6.03 ± 1.62 mm² (range 3.16–8.28), and ostial expansion was 90.2 ± 17.5% of expected (range 61.1-116.2). In the proximal main vessel, proximal stent area measured 10.74 ± 2.53 mm² (range 6.51–14.89), and proximal expansion ratio (observed/expected) was 0.95 ± 0.16 (range 0.79–1.20). IVUS confirmed complete coverage of the carina in all cases, with the characteristic double-layer metal configuration in the proximal main vessel clearly visible. The helical bioadaptor strut pattern demonstrated preserved inter-strut spacing and conformable apposition without distortion. No strut fractures, significant deformations, or malapposition were identified. The unlocking elements and polymer coating appeared intact in all cases. Full IVUS quantitative data are presented in Table 6 . Table 6 Quantitative IVUS measurements Parameter \ Patient 1 2 3 4 5 6 7 8 9 10 11 12 13 MB – Reference area (mm²) 4.65 9.01 8.77 6.29 7.77 5.08 9.75 6.14 6.8 9.53 6.62 8.34 4.99 MB – Distal stent area (mm²) 4.19 9.23 9.49 8.58 9.34 4.97 8.43 6.16 7.15 8.17 5.23 8.61 5.4 MB – Expansion (%) 79.1 97 71.3 123.2 96.3 87.4 85.5 94.5 103.4 86.4 72.5 94.2 91.4 MB – Minimal stent area (MSA, mm²) 3.68 8.74 6.25 7.75 7.48 4.44 8.34 5.8 7.03 8.23 4.8 7.86 4.56 MB – Expected ostial area (mm²)* 4.9 9.62 8.29 8.29 8.29 4.91 8.29 5.94 8.29 8.29 4.91 8.29 5.94 MB – Ostial stent area (mm²) 5.81 8.94 6.88 8.97 8.67 4.57 7.17 5.21 8.19 7.53 4.76 6.73 5.41 MB – Ostial expansion (% expected) 118.6 93 83 108.2 104.6 93.1 86.5 87.8 98.8 90.8 97 81.2 91.1 SB – Reference area (mm²) 3.8 5.8 5.29 7.35 4.63 3.5 9.16 4.27 5.7 7.55 5.18 8.87 6.16 SB – Distal stent area (mm²) 4.08 6.79 5.97 7.44 5.04 3.86 8.82 4.76 6 7.96 5.49 7.91 6.28 SB – Expansion (%) 86.3 99.5 83.2 92.9 107.6 97.4 90.7 114.8 100.7 88.1 96.3 74.6 96.6 SB – Minimal stent area (MSA, mm²) 3.28 5.77 4.4 6.83 4.98 3.41 8.31 4.9 5.74 6.65 4.99 6.62 5.95 SB – Expected ostial area (mm²)* 4.9 8.29 7.07 8.29 7.07 4.91 8.29 5.94 5.94 8.29 4.91 7.07 5.94 SB – Ostial stent area (mm²) 3.9 7.87 4.32 8.21 6.52 3.16 6.04 4.88 6.9 8.28 5.57 6.37 6.32 SB – Ostial expansion (% expected) 79.6 94.9 61.1 99 92.3 64.4 72.8 82.2 116.2 99.9 113.5 90.2 106.5 Proximal MB – Polygon of confluence area (mm²) 8.54 12.64 9.17 15.02 14.91 7.81 11.05 9.17 9.45 14.49 10.04 11.64 10.63 Proximal MB – Overlap area (mm²) 7.38 13.63 9.7 12.87 13.63 6.99 10.49 7.57 9.62 13.88 8.37 11.98 9.88 Proximal MB – Proximal stent area (mm²) 7.11 13.84 10.1 11.79 12.37 6.51 12.2 7.79 10.57 14.89 9.95 11.25 10.23 Proximal MB – Expected area (mm²)* 7.07 12.56 12.56 12.56 12.56 8.29 12.56 9.62 12.56 12.56 8.29 12.56 12.56 Proximal MB – Expansion (% expected) 1.01 1.1 0.8 0.94 0.98 0.79 0.97 0.81 0.84 1.19 1.2 0.9 0.81 *Expected area was derived from the theoretical circular luminal area corresponding to the nominal diameters of the kissing balloons at the bifurcation segments and the re-POT balloon at the proximal main-branch segment. MV – Main Vessel, SB- Side Branch Clinical Outcomes All patients were discharged successfully without in-hospital major adverse cardiac events. No deaths or emergency target vessel revascularization occurred. Three patients with baseline non–ST-segment elevation myocardial infarction exhibited troponin T elevations not exceeding the biomarker laboratory upper limit; no periprocedural myocardial infarction was diagnosed. One patient developed minor access-site hematoma managed conservatively. Procedural success was 100% (13 of 13 patients). DISCUSSION The present study represents the first systematic evaluation of DynamX Bioadaptor feasibility, safety, and acute procedural outcomes in complex bifurcation intervention using the technically demanding culotte technique. Our principal findings demonstrate that the bioadaptor's unique helical architecture and time-dependent uncaging mechanism are fully compatible with the technical and mechanical requirements of two-stent bifurcation techniques, achieving 100% technical success, 100% procedural success, and favorable IVUS-documented acute outcomes across all evaluated parameters. Technical Feasibility in Culotte Stenting Successful rewiring through deployed stent struts represents perhaps the most technically demanding and failure-prone step in culotte stenting, with significant implications for final procedural outcomes. 24 , 25 Failure to achieve distal cell crossing can result in incomplete ostial coverage with gap formation, increased stent malapposition at the ostium, and substantially elevated risk of side branch restenosis. 26 In the present series, rewiring was successful in 100% of attempts (26/26 total rewiring maneuvers). This success rate compares favorably with published literature, wherein previous investigations using conventional DES platforms have reported distal rewiring success rates ranging from 55% to approximately 90%. 27,28 The ultra-thin 71-µm strut thickness likely contributed substantially by creating reduced impedance to guidewire passage and enhanced fluoroscopic visibility. 29 IVUS Assessment Optimal stent expansion and complete apposition are critical determinants of both acute and long-term outcomes in bifurcation stenting. 30 , 31 Optical coherence tomography (OCT) studies have demonstrated that malapposition is particularly common at bifurcation sites, especially in the region of the side branch ostium and the polygon of confluence. 32 Systematic IVUS analysis demonstrated satisfactory expansion across all segments. Mean ostial expansion in the main branch reached 94.9% of expected with 84.6% of lesions achieving ≥ 80% expansion. Side branch ostial expansion (90.2%) showed greater variability, reflecting the technical sensitivity of side branch optimization. Proximal main vessel expansion ratio (0.95) demonstrated adequate conformability despite double-layer metal configuration, with no cases showing marked collapse. Comparison with Conventional DES Platforms The performance characteristics of the bioadaptor can be contextualized against conventional drug eluting stents used in culotte bifurcation PCI. Its 71 µm strut thickness places it within the ultra thin strut category, a feature associated with lower restenosis and stent thrombosis rates, particularly relevant in culotte configurations where proximal metal layers double.³³˒³⁴ Contemporary ultra thin platforms such as Orsiro and BioMime have demonstrated favorable bifurcation outcomes, ³⁵ and the bioadaptor platform falls within this advantageous range while uniquely incorporating amechanism that restores vessel function six months after the procedure. The L605 cobalt chromium alloy permits thin strut design while maintaining radial strength, an important attribute during sequential high pressure inflations required for POT and KBI.³⁶˒³ 7 In the present series, IVUS demonstrated consistent expansion without recoil or deformation, supporting the expected strength to thickness advantages of this material platform. Potential Long-Term Advantages Beyond demonstrating acute feasibility, the bioadaptor's uncaging mechanism may confer long-term advantages particularly relevant to bifurcation physiology. IVUS studies from the DynamX Mechanistic study documented significant increases in vessel area (3%) and device area (5%) at 9 months to 12 months while maintaining lumen area, indicating positive adaptive remodeling. 38 The BIOADAPTOR-RCT trial provided objective imaging evidence that following polymer resorption at approximately 6 months, lumen area increased 7.5% between systole and diastole, approximating untreated vessels, whereas conventional DES remained rigid. 39 In bifurcations, where flow dynamics are inherently complex with varying shear stress distribution, restoration of physiologic pulsatility might favorably modulate these adverse flow patterns. 40 This adaptive capacity could prove particularly beneficial at bifurcation sites, where conventional permanently caged stents prevent natural vessel adaptation and may contribute to late lumen loss and neoatherosclerosis. 41 Although culotte technique inevitably creates double-layer metal in the proximal segment, the bioadaptor’s mechanism theoretically permits partial strand separation after 6 months, potentially reducing effective metal burden compared with permanently overlapped conventional stents. 42 The ADAPT-CULOTTE case report demonstrated favorable 15-month outcomes, with angiography and OCT confirming excellent patency without neoatherosclerosis and restoration of physiologic pulsatility at the left main bifurcation. 21 This systematic study confirms the acute findings of the previous ADAPT-COULOTTE publications in a larger cohort. Study Limitations Key limitations include the small sample size (n = 13), single-center experience with expert operators, and lack of a control arm, limiting generalizability and comparative inference. Predefined exclusion criteria restrict applicability across bifurcation anatomies. The analysis is confined to acute procedural outcomes, with long-term clinical, angiographic, and imaging data unavailable. While IVUS was used, optical coherence tomography would provide higher-resolution strut-level assessment. CONCLUSIONS This first systematic evaluation demonstrates that bioadaptor implantation is highly feasible and safe for culotte bifurcation stenting. The ultra-thin (71-µm) cobalt-chromium helical architecture with time-dependent uncaging did not impede execution of this complex two-stent technique, achieving 100% technical and procedural success, complete rewiring with optimal distal cell crossing, successful final kissing balloon inflation, and favorable acute IVUS outcomes with satisfactory expansion and apposition across all bifurcation segments. These findings support further investigation in larger, multicenter studies comparing bioadaptive and other PCI platforms, with emphasis on long-term clinical and physiological outcomes. Abbreviations DES drug-eluting stent IVUS Intravascular Ultrasound KBI kissing balloon inflation MACE major adverse cardiac events PCI percutaneous coronary intervention POT proximal optimization technique RCT randomized controlled trial TLF target lesion failure Declarations Conflict of interest statement: The authors declare that there are no conflicts of interest regarding the publication of this paper. Ethics approval and consent to participate The study was approved by the hospital ethics committee: Hanoi Heart Hospital Ethics Committee, signed by the Director of the Hanoi Heart Hospital. Consent for publication The legal guardians of all participants received clear explanations of the data collection process and provided written informed consent before participation. Competing interests The authors declare that they have no competing interests Funding No Author Contribution The research hypothesis was introduced by Van Hoang. Giang Tran Tra, Dong Tran Van, Dung Tran Ngoc and Duong Nguyen Dang were responsible for the data collection. Data analysis was performed by Tien Tran Dinh, Cuong Pham Hung, revised by Dong Tran Van. Cuong Pham Hung and Dong Tran Van were responsible for writing the article. Van Hoang was responsible for final correction of the article. Dong Tran Van was responsible for revising the article after the first submission. Acknowledgements No Data Availability Datasets generated during and/or analyzed during the current study are publicly available, available upon reasonable request. References Hildick-Smith D, Lassen JF, Albiero R, et al. Consensus from the 5th European Bifurcation Club meeting. EuroIntervention. 2010;6:34–38. Lassen JF, Holm NR, Stankovic G, et al. Percutaneous coronary intervention for coronary bifurcation disease: consensus from the first 10 years of the European Bifurcation Club meetings. EuroIntervention. 2014;10:545–560. Sawaya FJ, Lefèvre T, Chevalier B, et al. 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JACC Cardiovasc Interv. 2014;7:325–333. Foin N, Torii R, Mortier P, et al. Kissing balloon or sequential dilation of the side branch and main vessel for provisional stenting of bifurcations: lessons from micro-computed tomography and computational simulations. JACC Cardiovasc Interv. 2012;5:47–56. Ormiston JA, Dixon SR, Webster MW, et al. Stent longitudinal flexibility: a comparison of 13 stent designs before and after balloon expansion. Catheter Cardiovasc Interv. 2000;50:120–124. Ormiston JA, Webber B, Ubod B, et al. Coronary stent durability and fracture: an independent bench comparison of six contemporary designs using a repetitive bend test. EuroIntervention. 2014;10:1449–1455. Verheye S, Vrolix M, Montorfano M, et al. Twelve-month clinical and imaging outcomes of the uncaging coronary DynamX bioadaptor system. EuroIntervention. 2020;16:e974-e981. Kandzari DE, Koolen JJ, Doros G, et al. Ultrathin bioresorbable polymer sirolimus-eluting stents versus thin durable polymer everolimus-eluting stents. J Am Coll Cardiol. 2018;72:3287–3297. Saito S, Krucoff MW, Nakamura S, et al. First randomized controlled trial comparing the sirolimus-eluting bioadaptor with the zotarolimus-eluting drug-eluting stent in patients with de novo coronary artery lesions: 12-month clinical and imaging data from the multi-centre, international, BIOADAPTOR-RCT. eClinicalMedicine. 2023;65:102304. Elixir Medical. DynamX Coronary Bioadaptor Breakthrough Designation. Available at: https://elixirmedical.com . Accessed January 2025. Erlinge D, Andersson J, Fröbert O, et al. Bioadaptor implant versus contemporary drug-eluting stent in percutaneous coronary interventions in Sweden (INFINITY-SWEDEHEART): a single-blind, non-inferiority, registry-based, randomized controlled trial. Lancet. 2024;404:1750–1759. Otsuka F, Byrne RA, Yahagi K, et al. Neoatherosclerosis: overview of histopathologic findings and implications for intravascular imaging assessment. Eur Heart J. 2015;36:2147–2159. Nakazawa G, Otsuka F, Nakano M, et al. The pathology of neoatherosclerosis in human coronary implants: bare-metal and drug-eluting stents. J Am Coll Cardiol. 2011;57:1314–1322. Wong SF, Chow HC, Chan K, Chung TS. The double bioadaptors culotte (ADAPT-CULOTTE) technique: from bench testing to the first-in-human longitudinal imaging analysis. JACC Cardiovasc Interv. 2024;17(24):2957–2960. doi: 10.1016/j.jcin.2024.09.059 Foin N, Sen S, Allegria E, et al. Maximal expansion capacity with current DES platforms: a critical factor for stent selection in the treatment of left main bifurcations? EuroIntervention. 2013;8:1315–1325. Murasato Y, Finet G, Foin N. Final kissing balloon inflation: the whole story. EuroIntervention. 2015;11 Suppl V:V81-85. Kang SJ, Mintz GS, Kim WJ, et al. Changes in left main bifurcation geometry after a single-stent crossover technique: an intravascular ultrasound study using direct imaging of both the left anterior descending and the left circumflex coronary arteries before and after intervention. Circ Cardiovasc Interv. 2011;4:355–361. Murasato Y, Hikichi Y, Horiuchi M. Examination of stent deformation and gap formation after complex stenting of left main coronary artery bifurcations using microfocus computed tomography. J Interv Cardiol. 2009;22:135–144. Grundeken MJ, Lesiak M, Asgedom S, et al. Importance of optimal rewiring guided by 3-dimensional optical frequency domain imaging during double-kissing culotte stenting demonstrated through a novel bench model. Sci Rep. 2023;13:13656. Pache J, Kastrati A, Mehilli J, et al. Intracoronary stenting and angiographic results: strut thickness effect on restenosis outcome (ISAR-STEREO-2) trial. J Am Coll Cardiol. 2003;41:1283–1288. Gutierrez-Chico JL, Wykrzykowska J, Nuesch E, et al. Vascular tissue reaction to acute malapposition in human coronary arteries: sequential assessment with optical coherence tomography. Circ Cardiovasc Interv. 2012;5:20–29. Räber L, Mintz GS, Koskinas KC, et al. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. EuroIntervention. 2018;14:656–677. Okamura T, Onuma Y, Yamada J, et al. 3D optical coherence tomography: new insights for bifurcation stenting. EuroIntervention. 2014;10:U51-58. Bangalore S, Toklu B, Amoroso N, et al. Bare metal stents, durable polymer drug eluting stents, and biodegradable polymer drug eluting stents for coronary artery disease: mixed treatment comparison meta-analysis. BMJ. 2013;347:f6625. Kastrati A, Mehilli J, Dirschinger J, et al. Intracoronary stenting and angiographic results: strut thickness effect on restenosis outcome (ISAR-STEREO) trial. Circulation. 2001;103:2816–2821. Naber CK, Urban P, Ong PJ, et al. Biolimus-A9 polymer-free coated stent in high bleeding risk patients with acute coronary syndrome: a Leaders Free ACS sub-study. Eur Heart J. 2017;38:961–969. O'Brien B, Carroll W. The evolution of cardiovascular stent materials and surfaces in response to clinical drivers: a review. Acta Biomater. 2009;5:945–958. Hermawan H, Dubé D, Mantovani D. Developments in metallic biodegradable stents. Acta Biomater. 2010;6:1693–1697. Chatzizisis YS, Coskun AU, Jonas M, et al. Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior. J Am Coll Cardiol. 2007;49:2379–2393. Verheye S, Morice MC, Zivelonghi C, et al. 24-Month clinical follow-up and mechanistic insights from intravascular imaging following coronary implantation of the novel DynamX bioadaptor platform. Cardiovasc Revasc Med. 2023;46:106–112. Webster MW, Cockerill I, Ormiston JA, et al. Percutaneous coronary intervention using the DynamX sirolimus-eluting bioadaptor: 12-month clinical and imaging outcomes. J Interv Cardiol. 2024;2024:8876443. Torii S, Jinnouchi H, Sakamoto A, et al. Drug-eluting coronary stents: insights from preclinical and pathology studies. Nat Rev Cardiol. 2020;17:37–51. Joner M, Finn AV, Farb A, et al. Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol. 2006;48:193–202. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 23 Apr, 2026 Reviews received at journal 15 Apr, 2026 Reviews received at journal 13 Apr, 2026 Reviewers agreed at journal 25 Mar, 2026 Reviewers agreed at journal 23 Mar, 2026 Reviewers invited by journal 22 Mar, 2026 Editor assigned by journal 19 Mar, 2026 Submission checks completed at journal 19 Mar, 2026 First submitted to journal 15 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9127530","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":610488325,"identity":"c3cf3dc4-aefc-48c8-b846-68aad6807419","order_by":0,"name":"Van Hoang","email":"","orcid":"","institution":"Hanoi Heart Hospital","correspondingAuthor":false,"prefix":"","firstName":"Van","middleName":"","lastName":"Hoang","suffix":""},{"id":610488326,"identity":"4be9bd18-1571-4d99-969a-fad0f00c9349","order_by":1,"name":"Tra Giang Tran","email":"","orcid":"","institution":"Hanoi Heart Hospital","correspondingAuthor":false,"prefix":"","firstName":"Tra","middleName":"Giang","lastName":"Tran","suffix":""},{"id":610488328,"identity":"3c5c37a5-913f-468a-8c20-6e4f011c815e","order_by":2,"name":"Ngoc Dung Tran","email":"","orcid":"","institution":"Hanoi Heart Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ngoc","middleName":"Dung","lastName":"Tran","suffix":""},{"id":610488330,"identity":"d3364bb7-37c4-4e8f-a452-5a44fc726ad4","order_by":3,"name":"Dang Duong Nguyen","email":"","orcid":"","institution":"Hanoi Heart Hospital","correspondingAuthor":false,"prefix":"","firstName":"Dang","middleName":"Duong","lastName":"Nguyen","suffix":""},{"id":610488331,"identity":"65fa872f-c82c-48e8-b395-486c5ed9f8f7","order_by":4,"name":"Van Dong Tran","email":"data:image/png;base64,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","orcid":"","institution":"Hanoi Heart Hospital","correspondingAuthor":true,"prefix":"","firstName":"Van","middleName":"Dong","lastName":"Tran","suffix":""},{"id":610488332,"identity":"a340a955-b241-470c-a9fa-afe1d40f18b8","order_by":5,"name":"Hung Cuong Pham","email":"","orcid":"","institution":"Hanoi Heart Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hung","middleName":"Cuong","lastName":"Pham","suffix":""},{"id":610488335,"identity":"206a23b9-e304-48a4-aca6-51c8c10e7767","order_by":6,"name":"Tien Tran Dinh","email":"","orcid":"","institution":"Hanoi Heart Hospital","correspondingAuthor":false,"prefix":"","firstName":"Tien","middleName":"Tran","lastName":"Dinh","suffix":""}],"badges":[],"createdAt":"2026-03-15 09:23:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9127530/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9127530/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105476637,"identity":"1fc32422-45ce-4984-83ad-25c05a9d1aba","added_by":"auto","created_at":"2026-03-26 12:59:10","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":130167,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 1 and video 1. Coronary angiography in a 69-year-old male with a history of hypertension and active smoking who presented with exertional left-sided chest pain. Percutaneous coronary angiography demonstrated a severe bifurcation lesion involving the left anterior descending artery (LAD) and the diagonal branch (Dg), with LAD dominance. The patient underwent percutaneous coronary intervention using the DK-culotte technique with two DynamX drug-eluting stents (2.5 × 28 mm and 2.5 × 33 mm). Post-procedural digital subtraction angiography (DSA) showed optimal stent expansion and restoration of coronary flow (Video 1A and 1B). Intravascular ultrasound (IVUS) confirmed adequate stent apposition and full expansion, particularly at the bifurcation segment, with satisfactory coverage of both the main vessel and side branch ostium (Figure 1A and 1B)\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9127530/v1/0d4a83d5fe0d2c87a24b6f5f.jpg"},{"id":105476638,"identity":"b2bc81a3-8b3a-4d16-bb4e-19f6476a93b1","added_by":"auto","created_at":"2026-03-26 12:59:10","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":97095,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 2. A 72-year-old male patient was admitted to the emergency department with severe angina and was diagnosed with non–st-segment elevation myocardial infarction. Transthoracic echocardiography demonstrated a left ventricular ejection fraction of 30%, a left ventricular end-diastolic diameter of 59 mm, and severe functional mitral regurgitation (carpentier type iiib). The patient underwent percutaneous coronary intervention with implantation of two dynamx drug-eluting stents (3.5 × 28 mm and 3.5 × 23 mm) using the culotte technique.\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9127530/v1/21dcae23bf739e7c67b0e33f.jpg"},{"id":105565772,"identity":"912325e0-7374-4dbb-a669-67824c97df8a","added_by":"auto","created_at":"2026-03-27 12:54:21","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":72907,"visible":true,"origin":"","legend":"\u003cp\u003eFigure 3 and video 2. Post-procedural imaging after culotte stenting with two dynamx drug-eluting stents. Intravascular ultrasound (ivus) assessment of the diagonal branch (dg; left video) and the left anterior descending artery (lad; right video) confirmed optimal stent apposition and full expansion, with adequate scaffolding at the bifurcation and no evidence of edge dissection or significant residual stenosis.\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9127530/v1/49cbc11eb8f9e5d2cd180610.jpg"},{"id":105570136,"identity":"d01ae730-0f23-4670-b355-eeb50cd94799","added_by":"auto","created_at":"2026-03-27 13:14:53","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1621600,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9127530/v1/2f6e4748-9416-4d2e-a713-42bfca47b660.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Feasibility and Short-Term Outcomes of Bioadaptor in Bifurcation Intervention Using Culotte Technique: Intravascular Ultrasound Analysis From a Single-Center Experience","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eCoronary bifurcation lesions account for approximately 15% to 20% of all percutaneous coronary interventions (PCI) and remain among the most technically challenging lesion subsets.\u0026sup1; Despite advances in stent platforms and procedural techniques, bifurcation PCI continues to be associated with higher rates of procedural complications, restenosis, and stent thrombosis compared with non-bifurcation lesions.\u0026sup2;˒\u0026sup3;\u003c/p\u003e \u003cp\u003eAlthough a provisional single-stent strategy is preferred for most bifurcation lesions, two-stent techniques are required in approximately 20% to 30% of true bifurcations, particularly when the side branch is large, diffusely diseased, or supplies substantial myocardium.⁴˒⁵ Among two-stent approaches, the culotte technique provides comprehensive carina and side-branch ostial coverage with favorable outcomes when combined with proximal optimization technique (POT) and final kissing balloon inflation (KBI).⁶˒⁷\u003c/p\u003e \u003cp\u003eSuccessful culotte stenting requires specific stent platform characteristics.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e These include thin strut thickness (\u0026lt;\u0026thinsp;80 \u0026micro;m) to minimize metal burden and flow disturbance,\u003csup\u003e10\u003c/sup\u003e adequate flexibility for navigating tortuous anatomy,\u003csup\u003e11\u003c/sup\u003e reliable rewirability through stent struts to enable distal cell crossing,\u003csup\u003e12,13\u003c/sup\u003e sufficient radial strength to resist recoil during high-pressure inflations,\u003csup\u003e14\u003c/sup\u003e and broad expansion capacity to accommodate vessel size mismatch without strut fracture.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe DynamX Bioadaptor (Elixir Medical Corporation, Milpitas, California) is a novel coronary implant designed to provide acute drug-eluting stent\u0026ndash;like performance while restoring long term vessel physiology.\u0026sup1;⁶˒\u0026sup1;⁷ The device consists of three 71-\u0026micro;m cobalt-chromium helical strands interconnected by bioresorbable polymer-coated uncaging elements that degrade over approximately six months, enabling strands to unlock, separate and adapt to vessel motion.\u003c/p\u003e \u003cp\u003eClinical evidence demonstrates favorable outcomes. The BIOADAPTOR randomized controlled trial demonstrated non-inferiority to contemporary zotarolimus-eluting stents at 12 months, with superior imaging endpoints including reduced late lumen loss and restoration of cyclic pulsatility.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e At 2-year follow-up, the trial demonstrated a statistically significant 65% reduction in target lesion failure (1.9% vs 5.5%, p\u0026thinsp;=\u0026thinsp;0.046).\u003csup\u003e19\u003c/sup\u003e The INFINITY-SWEDEHEART trial subsequently confirmed these findings, demonstrating 48% reduction in target lesion failure (hazard ratio: 0.52, 95% confidence interval: 0.29\u0026ndash;0.93, p\u0026thinsp;=\u0026thinsp;0.027) in the landmark analysis from 6 months through 2 years.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe culotte technique requires sequential rewiring and creates double metal layers proximally, providing a large mechanical stresses on the implant. The bioadaptor mechanism of action may offer long term advantages in bifurcations which are associated with adverse shear stresses that promote neoatherosclerosis and late stent thrombosis.\u0026sup2;\u0026sup1;˒\u0026sup2;\u0026sup2; Preliminary evidence supporting this approach was reported in the ADAPT-CULOTTE study, describing double bioadaptors in culotte configuration,\u0026sup2;\u0026sup3; and the present analysis further evaluated the technical feasibility, expansion characteristics, and acute intravascular ultrasound outcomes of the bioadaptor in planned culotte bifurcation PCI.\u003c/p\u003e \u003cp\u003eDespite these results, the performance of the bioadaptor in complex bifurcation PCI using two-stent strategies remains undefined. This study reports the first systematic evaluation of bioadaptor feasibility in culotte bifurcation PCI using comprehensive intravascular ultrasound analysis.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003eBetween February 2025 and October 2025, we prospectively enrolled 13 consecutive patients undergoing bifurcation PCI using the culotte technique with DynamX Bioadaptor at the Department of Interventional Cardiology, Hanoi Heart Hospital. All patients provided written informed consent prior to enrollment. The institutional ethics committee approved the study protocol, which was conducted in accordance with the Declaration of Helsinki.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Population\u003c/h2\u003e \u003cp\u003eInclusion criteria comprised symptomatic coronary artery disease with established indication for revascularization, de novo true bifurcation lesion classified as Medina 1,1,1; 1,0,1; or 0,1,1 morphology, side branch reference diameter\u0026thinsp;\u0026ge;\u0026thinsp;2.5 mm by visual estimation, side branch lesion length\u0026thinsp;\u0026gt;\u0026thinsp;5 mm or presence of ostial disease, and absence of significant size mismatch between proximal main vessel and side branch. Exclusion criteria included cardiogenic shock, severe calcification requiring rotational atherectomy, and contraindication to dual antiplatelet therapy.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eProcedural Technique\u003c/h3\u003e\n\u003cp\u003eAll procedures were performed via transradial or transfemoral access using 6-F or 7-F guide catheters. Culotte stenting followed a standardized protocol: (1) dual-wire lesion preparation with balloon predilatation and IVUS before or immediately after predilatation; (2) first stent deployment in the more angulated branch using a bioadaptor sized 1:1 to the distal reference diameter, protruding 2\u0026ndash;3 mm into the proximal main vessel; (3) first proximal optimization technique (POT); (4) rewiring through stent struts with distal cell crossing and strut dilation using a 1.5\u0026ndash;2.0 mm balloon; (5) second stent deployment in the main vessel; (6) second POT; (7) side-branch rewiring; (8) final kissing balloon inflation with two noncompliant balloons sized 1:1; (9) final POT to restore circular geometry; and (10) final IVUS assessment of all segments.\u003c/p\u003e\n\u003ch3\u003eIntravascular Ultrasound Protocol\u003c/h3\u003e\n\u003cp\u003eIVUS was performed using the AVVIGO Guidance System (Boston Scientific, Maple Grove, Minnesota) with automated 0.5-mm/s pullback. Quantitative IVUS analysis assessed minimal lumen area, stent area and expansion, stent apposition assessment with malapposition defined as \u0026gt;\u0026thinsp;200 \u0026micro;m separation between strut and vessel wall, assessment of strut layers in the proximal overlapping segment, coverage of the carina and side branch ostium, and evaluation for edge dissection or tissue prolapse. Qualitative analysis evaluated helical bioadaptor visibility, strut distribution, and structural abnormalities, including fracture or deformation.\u003c/p\u003e\n\u003ch3\u003eStudy Endpoints\u003c/h3\u003e\n\u003cp\u003eThe primary endpoint was technical success, defined as successful deployment of both bioadaptor stents with \u0026lt;\u0026thinsp;30% residual stenosis by visual assessment and TIMI flow grade 3 in both branches. Secondary endpoints included procedural success (technical success without in-hospital major adverse cardiac events [death, myocardial infarction, or urgent target vessel revascularization]), rewiring success rate through stent struts, final KBI success rate, IVUS-defined stent expansion and apposition, procedural complications, fluoroscopy time, and contrast volume.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eContinuous variables are expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or median (interquartile range) depending on distribution. Categorical variables are presented as frequencies and percentages. Given the exploratory nature and limited sample size, formal statistical hypothesis testing was not performed.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eBaseline Characteristics\u003c/h2\u003e \u003cp\u003eThirteen patients (mean age 60.3\u0026thinsp;\u0026plusmn;\u0026thinsp;9.8 years; 85% male) were enrolled. Mean body mass index was 22.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0 kg/m\u0026sup2;. Clinical presentation comprised chronic coronary syndrome in 8 patients (62%), non\u0026ndash;ST-segment elevation myocardial infarction in 3 patients (23%), and unstable angina in 1 patient (8%). Cardiovascular risk factors included current or former smoking in 9 patients (70%), diabetes mellitus in 5 patients (38.5%), and hypertension in 6 patients (46.2%). Mean estimated glomerular filtration rate was 79.2\u0026thinsp;\u0026plusmn;\u0026thinsp;19.1 mL/min/1.73 m\u0026sup2;, mean low-density lipoprotein cholesterol was 2.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71 mmol/L, and mean left ventricular ejection fraction was 59.3\u0026thinsp;\u0026plusmn;\u0026thinsp;15.4%. Baseline characteristics are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline patient characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eValue (N\u0026thinsp;=\u0026thinsp;13)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60.3\u0026thinsp;\u0026plusmn;\u0026thinsp;9.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale sex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (84.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBody mass index, kg/m\u0026sup2;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCurrent or former smoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (69.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (38.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (46.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChronic coronary syndrome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (61.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNSTEMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (23.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnstable angina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (7.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eeGFR, mL/min/1.73 m\u0026sup2;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79.2\u0026thinsp;\u0026plusmn;\u0026thinsp;19.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDL cholesterol, mmol/L\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeft ventricular ejection fraction, %\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59.3\u0026thinsp;\u0026plusmn;\u0026thinsp;15.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTarget bifurcation lesions were distributed in the left anterior descending/diagonal bifurcation in 9 cases (69%), left circumflex/obtuse marginal bifurcation in 3 cases (23%), and posterior descending artery\u0026ndash;posterolateral ventricular branch in 1 case (8%). According to Medina classification, lesion distribution comprised 1,1,1 morphology in 12 cases (92.3%) and 0,1,1 morphology in 1 case (7.7%) as summarized in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Mean bifurcation angle measured 64\u0026deg; \u0026plusmn; 28\u0026deg;.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLesion characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eValue\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eCulprit vessel\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAD\u0026ndash;Diagonal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (69.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLCx\u0026ndash;Obtuse marginal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (23.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePDA\u0026ndash;PLV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (7.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eBifurcation type\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedina 1,1,1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (84.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedina 0,1,1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (7.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedina 1,0,1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eProcedural Outcomes\u003c/h3\u003e\n\u003cp\u003eTechnical success was achieved in all 13 patients (100%). All bioadaptor stents were successfully delivered to intended positions, deployed, and adequately expanded according to IVUS criteria. The helical architecture did not create deliverability challenges or impede navigation through guide catheters or tortuous segments in any case.\u003c/p\u003e \u003cp\u003eRewiring through deployed stent struts was accomplished successfully in all cases for both initial (13 of 13, 100%) and subsequent (13 of 13, 100%) rewiring maneuvers. Mean time required for initial rewiring was 39.2\u0026thinsp;\u0026plusmn;\u0026thinsp;19.0 seconds (range 15\u0026ndash;75 seconds), whereas subsequent rewiring required 206.9\u0026thinsp;\u0026plusmn;\u0026thinsp;162.4 seconds (range 45\u0026ndash;600 seconds). Distal cell crossing, the preferred rewiring position, was achieved as intended in all cases without need to accept proximal cell positioning as a compromise. The helical structure with uncaging elements created a cell pattern that operators noted facilitated guidewire crossing.\u003c/p\u003e \u003cp\u003eFinal KBI was performed successfully in all cases (13 of 13, 100%), with complete simultaneous balloon expansion without residual waist observed in all procedures. POT was systematically executed at 3 time points in all cases. Mean procedure time was 55.2\u0026thinsp;\u0026plusmn;\u0026thinsp;20.7 minutes, mean fluoroscopy time was 38.4\u0026thinsp;\u0026plusmn;\u0026thinsp;17.6 minutes, and mean contrast volume was 218.0\u0026thinsp;\u0026plusmn;\u0026thinsp;54.9 mL. Procedural outcomes are detailed in Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eProcedural characteristics \u0026ndash; Devices and technique (patient-level)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026times;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026times;\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient No.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMain vessel pre-dilatation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSide branch pre-dilatation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMain vessel stent (mm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSide branch stent (mm)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSemi-compliant 2.0, 18 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSemi-compliant 2.0, 18 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e2.5 \u0026times; 28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e2.5 \u0026times; 33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSemi-compliant 2.5, 18 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSemi-compliant 2.5, 18 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.5 \u0026times; 28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e3.5 \u0026times; 23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-slip element 3.0, 24 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon-slip element 3.0, 24 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.5 \u0026times; 28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e3.0 \u0026times; 28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot performed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNot performed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.5 \u0026times; 28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e3.0 \u0026times; 18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-slip element 3.0, 20 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNot performed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.0 \u0026times; 32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e3.0 \u0026times; 18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e6\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eScoring 2.0, 24 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNot performed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e2.75 \u0026times; 23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e2.5 \u0026times; 18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e7\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCutting 2.75, 20 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSemi-compliant 2.5, 14 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.5 \u0026times; 23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e3.5 \u0026times; 18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e8\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eScoring 2.75, 16 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eScoring 2.75, 14 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.0 \u0026times; 38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e3.0 \u0026times; 32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e9\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-compliant 3.5, 14 atm\u0026thinsp;+\u0026thinsp;Cutting 2.75, 14 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eScoring 2.0, 24 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.5 \u0026times; 23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e3.0 \u0026times; 23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e10\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eScoring 3.0, 24 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eScoring 3.0, 24 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.5 \u0026times; 23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e3.5 \u0026times; 32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e11\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCutting 2.5, 12 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSemi-compliant 2.0, 20 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.0 \u0026times; 28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e2.75 \u0026times; 23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e12\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCutting 2.75, 18 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSemi-compliant 2.0, 16 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.5 \u0026times; 38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e3.5 \u0026times; 18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e13\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot performed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSemi-compliant 2.0, 14 atm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c4\"\u003e \u003cp\u003e3.0 \u0026times; 38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026times;\" colname=\"c5\"\u003e \u003cp\u003e3.0 \u0026times; 28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eProcedural characteristics \u0026ndash; Optimization (patient-level)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatient No.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMain vessel post-dilatation (mm, atm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSide branch post-dilatation (mm, atm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFinal kissing (MV diameter, atm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFinal kissing (SB diameter, atm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePOT (mm, atm)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.75, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.75, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.5, 10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.5, 10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.0, 18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.5, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.25, 20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.5, 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.25, 18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.0, 16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.5, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.5, 20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.25, 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.0, 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.0, 12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.5, 20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.5, 20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.25, 16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.25, 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.0, 18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.25, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.0, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.25, 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.0, 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.0, 12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.25, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.5, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.5, 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.5, 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.25, 16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.5, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.5, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.25, 16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.25, 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.0, 16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.5, 20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.5, 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.75, 16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.75, 18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.5, 18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.5, 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.75, 20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.25, 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.75, 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.0, 8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.25, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.25, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.25, 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.25, 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.0, 14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.75, 20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.75, 18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.5, 16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.5, 16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.25, 22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.5, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.5, 22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.25, 16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.0, 16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.0, 22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.5, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.0, 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.75, 16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.75, 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.0, 8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eMV \u0026ndash; Main Vessel, SB- Side Branch\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eProcedural metrics (overall)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eValue (N\u0026thinsp;=\u0026thinsp;13)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal rewiring time, s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e246.2\u0026thinsp;\u0026plusmn;\u0026thinsp;171.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContrast volume, mL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e218.0\u0026thinsp;\u0026plusmn;\u0026thinsp;54.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRadiation dose, mGy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e1288.7\u0026thinsp;\u0026plusmn;\u0026thinsp;666.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluoroscopy time, min\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e38.36\u0026thinsp;\u0026plusmn;\u0026thinsp;17.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eIVUS Analysis\u003c/h2\u003e \u003cp\u003eComprehensive IVUS imaging with complete quantitative analysis was successfully performed in all 13 patients. In the main branch, mean reference area measured 7.21\u0026thinsp;\u0026plusmn;\u0026thinsp;1.77 mm\u0026sup2; (range 4.65\u0026ndash;9.75), distal stent area measured 7.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.88 mm\u0026sup2; (range 4.19\u0026ndash;9.49), and overall expansion was 90.9\u0026thinsp;\u0026plusmn;\u0026thinsp;13.6% (range 71.3-123.2). At the main branch ostium, expected ostial area measured 7.25\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66 mm\u0026sup2; (range 4.90\u0026ndash;9.62), achieved ostial stent area measured 6.83\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58 mm\u0026sup2; (range 4.57\u0026ndash;8.97), and ostial expansion was 94.9\u0026thinsp;\u0026plusmn;\u0026thinsp;10.6% of expected (range 81.2-118.6).\u003c/p\u003e \u003cp\u003eIn the side branch, mean reference area measured 5.94\u0026thinsp;\u0026plusmn;\u0026thinsp;1.82 mm\u0026sup2; (range 3.50\u0026ndash;9.16), distal stent area measured 6.18\u0026thinsp;\u0026plusmn;\u0026thinsp;1.55 mm\u0026sup2; (range 3.86\u0026ndash;8.82), and overall expansion was 94.5\u0026thinsp;\u0026plusmn;\u0026thinsp;10.5% (range 74.6-114.8). At the side branch ostium, expected ostial area measured 6.69\u0026thinsp;\u0026plusmn;\u0026thinsp;1.35 mm\u0026sup2; (range 4.90\u0026ndash;8.29), achieved ostial stent area measured 6.03\u0026thinsp;\u0026plusmn;\u0026thinsp;1.62 mm\u0026sup2; (range 3.16\u0026ndash;8.28), and ostial expansion was 90.2\u0026thinsp;\u0026plusmn;\u0026thinsp;17.5% of expected (range 61.1-116.2). In the proximal main vessel, proximal stent area measured 10.74\u0026thinsp;\u0026plusmn;\u0026thinsp;2.53 mm\u0026sup2; (range 6.51\u0026ndash;14.89), and proximal expansion ratio (observed/expected) was 0.95\u0026thinsp;\u0026plusmn;\u0026thinsp;0.16 (range 0.79\u0026ndash;1.20).\u003c/p\u003e \u003cp\u003eIVUS confirmed complete coverage of the carina in all cases, with the characteristic double-layer metal configuration in the proximal main vessel clearly visible. The helical bioadaptor strut pattern demonstrated preserved inter-strut spacing and conformable apposition without distortion. No strut fractures, significant deformations, or malapposition were identified. The unlocking elements and polymer coating appeared intact in all cases. Full IVUS quantitative data are presented in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eQuantitative IVUS measurements\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"14\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameter \\ Patient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMB \u0026ndash; Reference area (mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e5.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e9.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e6.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e6.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e9.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e6.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e8.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e4.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMB \u0026ndash; Distal stent area (mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e6.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e7.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e8.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e5.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e8.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e5.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMB \u0026ndash; Expansion (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e123.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e96.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e87.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e85.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e94.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e103.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e86.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e72.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e94.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e91.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMB \u0026ndash; Minimal stent area (MSA, mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e7.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e8.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e7.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e4.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMB \u0026ndash; Expected ostial area (mm\u0026sup2;)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e5.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMB \u0026ndash; Ostial stent area (mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e7.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e8.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e7.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e6.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e5.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMB \u0026ndash; Ostial expansion (% expected)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e118.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e108.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e104.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e93.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e86.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e87.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e98.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e90.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e81.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e91.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSB \u0026ndash; Reference area (mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e9.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e7.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e5.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e8.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e6.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSB \u0026ndash; Distal stent area (mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e7.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e5.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e7.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e6.28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSB \u0026ndash; Expansion (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e86.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e92.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e107.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e97.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e90.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e114.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e100.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e88.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e96.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e74.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e96.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSB \u0026ndash; Minimal stent area (MSA, mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e5.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e6.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e6.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e5.95\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSB \u0026ndash; Expected ostial area (mm\u0026sup2;)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e5.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e4.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e7.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e5.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSB \u0026ndash; Ostial stent area (mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e6.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e6.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e6.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e8.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e5.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e6.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e6.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSB \u0026ndash; Ostial expansion (% expected)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e61.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e92.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e64.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e72.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e82.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e116.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e99.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e113.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e90.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e106.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProximal MB \u0026ndash; Polygon of confluence area (mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e7.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e11.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e9.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e9.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e14.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e10.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e11.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e10.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProximal MB \u0026ndash; Overlap area (mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e13.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e10.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e7.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e9.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e13.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e8.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e11.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e9.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProximal MB \u0026ndash; Proximal stent area (mm\u0026sup2;)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e12.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e12.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e7.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e10.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e14.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e9.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e11.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e10.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProximal MB \u0026ndash; Expected area (mm\u0026sup2;)*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e12.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e12.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e9.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e12.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e12.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e8.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e12.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e12.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProximal MB \u0026ndash; Expansion (% expected)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"14\"\u003e\u003cem\u003e*Expected area was derived from the theoretical circular luminal area corresponding to the nominal diameters of the kissing balloons at the bifurcation segments and the re-POT balloon at the proximal main-branch segment.\u003c/em\u003e MV \u0026ndash; Main Vessel, SB- Side Branch\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eClinical Outcomes\u003c/h2\u003e \u003cp\u003eAll patients were discharged successfully without in-hospital major adverse cardiac events. No deaths or emergency target vessel revascularization occurred. Three patients with baseline non\u0026ndash;ST-segment elevation myocardial infarction exhibited troponin T elevations not exceeding the biomarker laboratory upper limit; no periprocedural myocardial infarction was diagnosed. One patient developed minor access-site hematoma managed conservatively. Procedural success was 100% (13 of 13 patients).\u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe present study represents the first systematic evaluation of DynamX Bioadaptor feasibility, safety, and acute procedural outcomes in complex bifurcation intervention using the technically demanding culotte technique. Our principal findings demonstrate that the bioadaptor's unique helical architecture and time-dependent uncaging mechanism are fully compatible with the technical and mechanical requirements of two-stent bifurcation techniques, achieving 100% technical success, 100% procedural success, and favorable IVUS-documented acute outcomes across all evaluated parameters.\u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eTechnical Feasibility in Culotte Stenting\u003c/h2\u003e \u003cp\u003eSuccessful rewiring through deployed stent struts represents perhaps the most technically demanding and failure-prone step in culotte stenting, with significant implications for final procedural outcomes.\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e,\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e Failure to achieve distal cell crossing can result in incomplete ostial coverage with gap formation, increased stent malapposition at the ostium, and substantially elevated risk of side branch restenosis.\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e In the present series, rewiring was successful in 100% of attempts (26/26 total rewiring maneuvers). This success rate compares favorably with published literature, wherein previous investigations using conventional DES platforms have reported distal rewiring success rates ranging from 55% to approximately 90%.\u003csup\u003e27,28\u003c/sup\u003e The ultra-thin 71-\u0026micro;m strut thickness likely contributed substantially by creating reduced impedance to guidewire passage and enhanced fluoroscopic visibility.\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eIVUS Assessment\u003c/h2\u003e \u003cp\u003eOptimal stent expansion and complete apposition are critical determinants of both acute and long-term outcomes in bifurcation stenting.\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e,\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e Optical coherence tomography (OCT) studies have demonstrated that malapposition is particularly common at bifurcation sites, especially in the region of the side branch ostium and the polygon of confluence.\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eSystematic IVUS analysis demonstrated satisfactory expansion across all segments. Mean ostial expansion in the main branch reached 94.9% of expected with 84.6% of lesions achieving\u0026thinsp;\u0026ge;\u0026thinsp;80% expansion. Side branch ostial expansion (90.2%) showed greater variability, reflecting the technical sensitivity of side branch optimization. Proximal main vessel expansion ratio (0.95) demonstrated adequate conformability despite double-layer metal configuration, with no cases showing marked collapse.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eComparison with Conventional DES Platforms\u003c/h2\u003e \u003cp\u003eThe performance characteristics of the bioadaptor can be contextualized against conventional drug eluting stents used in culotte bifurcation PCI. Its 71 \u0026micro;m strut thickness places it within the ultra thin strut category, a feature associated with lower restenosis and stent thrombosis rates, particularly relevant in culotte configurations where proximal metal layers double.\u0026sup3;\u0026sup3;˒\u0026sup3;⁴ Contemporary ultra thin platforms such as Orsiro and BioMime have demonstrated favorable bifurcation outcomes, \u0026sup3;⁵ and the bioadaptor platform falls within this advantageous range while uniquely incorporating amechanism that restores vessel function six months after the procedure. The L605 cobalt chromium alloy permits thin strut design while maintaining radial strength, an important attribute during sequential high pressure inflations required for POT and KBI.\u0026sup3;⁶˒\u0026sup3;\u003csup\u003e7\u003c/sup\u003e In the present series, IVUS demonstrated consistent expansion without recoil or deformation, supporting the expected strength to thickness advantages of this material platform.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003ePotential Long-Term Advantages\u003c/h2\u003e \u003cp\u003eBeyond demonstrating acute feasibility, the bioadaptor's uncaging mechanism may confer long-term advantages particularly relevant to bifurcation physiology. IVUS studies from the DynamX Mechanistic study documented significant increases in vessel area (3%) and device area (5%) at 9 months to 12 months while maintaining lumen area, indicating positive adaptive remodeling.\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe BIOADAPTOR-RCT trial provided objective imaging evidence that following polymer resorption at approximately 6 months, lumen area increased 7.5% between systole and diastole, approximating untreated vessels, whereas conventional DES remained rigid.\u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e In bifurcations, where flow dynamics are inherently complex with varying shear stress distribution, restoration of physiologic pulsatility might favorably modulate these adverse flow patterns.\u003csup\u003e\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThis adaptive capacity could prove particularly beneficial at bifurcation sites, where conventional permanently caged stents prevent natural vessel adaptation and may contribute to late lumen loss and neoatherosclerosis.\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e Although culotte technique inevitably creates double-layer metal in the proximal segment, the bioadaptor\u0026rsquo;s mechanism theoretically permits partial strand separation after 6 months, potentially reducing effective metal burden compared with permanently overlapped conventional stents.\u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e The ADAPT-CULOTTE case report demonstrated favorable 15-month outcomes, with angiography and OCT confirming excellent patency without neoatherosclerosis and restoration of physiologic pulsatility at the left main bifurcation.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e This systematic study confirms the acute findings of the previous ADAPT-COULOTTE publications in a larger cohort.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eStudy Limitations\u003c/h2\u003e \u003cp\u003eKey limitations include the small sample size (n\u0026thinsp;=\u0026thinsp;13), single-center experience with expert operators, and lack of a control arm, limiting generalizability and comparative inference. Predefined exclusion criteria restrict applicability across bifurcation anatomies. The analysis is confined to acute procedural outcomes, with long-term clinical, angiographic, and imaging data unavailable. While IVUS was used, optical coherence tomography would provide higher-resolution strut-level assessment.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSIONS","content":"\u003cp\u003eThis first systematic evaluation demonstrates that bioadaptor implantation is highly feasible and safe for culotte bifurcation stenting. The ultra-thin (71-\u0026micro;m) cobalt-chromium helical architecture with time-dependent uncaging did not impede execution of this complex two-stent technique, achieving 100% technical and procedural success, complete rewiring with optimal distal cell crossing, successful final kissing balloon inflation, and favorable acute IVUS outcomes with satisfactory expansion and apposition across all bifurcation segments. These findings support further investigation in larger, multicenter studies comparing bioadaptive and other PCI platforms, with emphasis on long-term clinical and physiological outcomes.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eDES\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;drug-eluting stent\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIVUS\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Intravascular Ultrasound\u003c/p\u003e\n\u003cp\u003eKBI\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;kissing balloon inflation\u003c/p\u003e\n\u003cp\u003eMACE\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;major adverse cardiac events\u003c/p\u003e\n\u003cp\u003ePCI\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;percutaneous coronary intervention\u003c/p\u003e\n\u003cp\u003ePOT\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;proximal optimization technique\u003c/p\u003e\n\u003cp\u003eRCT\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;randomized controlled trial\u003c/p\u003e\n\u003cp\u003eTLF \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; target lesion failure\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eConflict of interest statement:\u003c/h2\u003e \u003cp\u003eThe authors declare that there are no conflicts of interest regarding the publication of this paper.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003e The study was approved by the hospital ethics committee: Hanoi Heart Hospital Ethics Committee, signed by the Director of the Hanoi Heart Hospital.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003e The legal guardians of all participants received clear explanations of the data collection process and provided written informed consent before participation.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eNo\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eThe research hypothesis was introduced by Van Hoang. Giang Tran Tra, Dong Tran Van, Dung Tran Ngoc and Duong Nguyen Dang were responsible for the data collection. Data analysis was performed by Tien Tran Dinh, Cuong Pham Hung, revised by Dong Tran Van. Cuong Pham Hung and Dong Tran Van were responsible for writing the article. Van Hoang was responsible for final correction of the article. Dong Tran Van was responsible for revising the article after the first submission.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003eNo\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eDatasets generated during and/or analyzed during the current study are publicly available, available upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHildick-Smith D, Lassen JF, Albiero R, et al. Consensus from the 5th European Bifurcation Club meeting. 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J Am Coll Cardiol. 2007;49:2379\u0026ndash;2393.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVerheye S, Morice MC, Zivelonghi C, et al. 24-Month clinical follow-up and mechanistic insights from intravascular imaging following coronary implantation of the novel DynamX bioadaptor platform. Cardiovasc Revasc Med. 2023;46:106\u0026ndash;112.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWebster MW, Cockerill I, Ormiston JA, et al. Percutaneous coronary intervention using the DynamX sirolimus-eluting bioadaptor: 12-month clinical and imaging outcomes. J Interv Cardiol. 2024;2024:8876443.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTorii S, Jinnouchi H, Sakamoto A, et al. Drug-eluting coronary stents: insights from preclinical and pathology studies. Nat Rev Cardiol. 2020;17:37\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJoner M, Finn AV, Farb A, et al. Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol. 2006;48:193\u0026ndash;202.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-cardiovascular-imaging","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Journal of Cardiovascular Imaging](https://jcvi.biomedcentral.com/)","snPcode":"44348","submissionUrl":"https://submission.springernature.com/new-submission/44348/3","title":"Journal of Cardiovascular Imaging","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"bifurcation PCI, coronary bioadaptor, culotte technique, DynamX, intravascular ultrasound, two-stent strategy","lastPublishedDoi":"10.21203/rs.3.rs-9127530/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9127530/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBACKGROUND\u003c/h2\u003e \u003cp\u003eThe DynamX Bioadaptor is a novel coronary implant with three helical strands that unlock and separate to provide dynamic vessel support restoring natural vessel function. Evidence in complex bifurcation lesions requiring planned two-stent strategies is limited. This analysis evaluated the feasibility and short-term outcomes of culotte bioadaptor implantation using intravascular ultrasound.\u003c/p\u003e\u003ch2\u003eMETHODS\u003c/h2\u003e \u003cp\u003eThirteen consecutive patients underwent bifurcation percutaneous coronary intervention using culotte technique with DynamX Bioadaptor between February and October 2025. All procedures followed a standardized culotte protocol with lesion preparation, POT, rewiring, and final kissing balloon inflation, with intravascular ultrasound used to assess bioadaptor expansion, apposition, and structural integrity.\u003c/p\u003e\u003ch2\u003eRESULTS\u003c/h2\u003e \u003cp\u003eTechnical and procedural success was achieved in all patients (100%), with successful rewiring through bioadaptor struts in all attempts (26/26, 100%). Intravascular ultrasound demonstrated satisfactory expansion: main branch ostial expansion 94.9\u0026thinsp;\u0026plusmn;\u0026thinsp;10.6%, side branch ostial expansion 90.2\u0026thinsp;\u0026plusmn;\u0026thinsp;17.5%, proximal expansion ratio 0.95\u0026thinsp;\u0026plusmn;\u0026thinsp;0.16. No strut fractures or malapposition occurred.\u003c/p\u003e\u003ch2\u003eCONCLUSIONS\u003c/h2\u003e \u003cp\u003eThis first systematic evaluation demonstrates that bioadaptor implantation is highly feasible for culotte bifurcation stenting, achieving complete rewiring success and favorable acute intravascular ultrasound outcomes without compromising deliverability or structural integrity.\u003c/p\u003e","manuscriptTitle":"Feasibility and Short-Term Outcomes of Bioadaptor in Bifurcation Intervention Using Culotte Technique: Intravascular Ultrasound Analysis From a Single-Center Experience","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-26 12:59:05","doi":"10.21203/rs.3.rs-9127530/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-23T09:31:21+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-15T14:35:59+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-13T05:41:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"112091058538378986938555025037296646183","date":"2026-03-25T04:21:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"135151868527567907184051404968711182207","date":"2026-03-23T08:02:51+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-23T03:18:28+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-19T07:44:59+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-19T07:44:11+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Cardiovascular Imaging","date":"2026-03-15T09:19:45+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-cardiovascular-imaging","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Journal of Cardiovascular Imaging](https://jcvi.biomedcentral.com/)","snPcode":"44348","submissionUrl":"https://submission.springernature.com/new-submission/44348/3","title":"Journal of Cardiovascular Imaging","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"acd87c78-3af1-4f3b-96ed-9f0353f00698","owner":[],"postedDate":"March 26th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-12T22:38:26+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-26 12:59:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9127530","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9127530","identity":"rs-9127530","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}