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240
LATIB ET AL.
(O)
Figure 11 (
Sideguard
Continued
A second multicenter nonrandomized trial has been completed with the next-generation
TM
)
device (SG-2). The new SideguardTMdevice has undergone minor changes to
the SDS and a major change to the stent design. The stent has a mixed open and closed cell
design with a new mid-distal open cell that acts as a built-in anchoring system preventing
the Sideguard
93 patients enrolled in the Sideguard
TM
from migrating following deployment. The technical success overall in the
TM
FIM trials is 86%; however with design changes mentioned above, the device success increased to 97%. Interim results from the combined SG-1 and
SG-2 FIM trialsshowed a MACE rate of4.8% at 30 days and 10.8% atsix months. An interesting
IVUS substudy performed on 11 patients suggests furtherstent expansion at thecarina preserving ostial lumen dimensions (30). The SB stent area (at the carina) increased from 3.9 ± 1.2 to
4.6 ± 1.1 mm
p =0.77) despitean intimalhyperplasia areaof 0.6 ±0.7 mm
expansion due to the self-expanding nitinol properties of the Sideguard
2
(p = 0.04), resulting in no change in lumen area (3.9 ± 1.3 vs. 4.0 ± 1.3 mm2,
2
. Thisdata suggestthat chronicstent
TM
may be sufficient to
compensate for the late loss that occurs with this bare-metal stent.
TrytonTM(Tryton Medical)
The Tryton
TM
SB stent (Fig. 12) is a slotted tube, cobalt chromium balloon expandable stent
designed to be implanted in the SB of a bifurcation. The stent consists of three zones: a distal
SB zone (that treats the disease in the SB); a transition zone (positioned at the SB ostium);
and an MB zone. The central transition zone has a specific geometry, which contains three
panels, each of which can be deformed in an independent fashion. The proximal MB zone is
composed of three fronds that are connected proximally to the transitional panel and terminate
in a circumferential band and the distal zone has the design characteristics of a standard slotted
tube workhorse stent. Treatment of a bifurcation with the Tryton
TM
stent generally commits the
operator to implant two stents in the bifurcation, and the technique is identical in approach
CURRENT STATUS AND FUTURE OF DEDICATED BIFURCATION STENT SYSTEMS
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241
when performing the Culotte technique. The TrytonTMstent is deployed across the SB ostium
first. The initial FIM experience has shown that predilatation of the Tryton
allow a MB stent to be advanced through the Tryton
then tracked through the proximal MB zone of the Tryton
TM
struts (31,32). A standard MB stent is
TM
into the distal MB and deployed.
TM
The MB stent struts then have to be recrossed in order to perform a final kissing inflation.
(A)
(B)
Figure 12 (A) The design features and characteristics of the TrytonTMSB stent. Baseline angiography demon-
strating a complex true bifurcation lesion of the left anterior descending artery and large first diagonal branch
(B). Both branches of the bifurcation were wired and predilated (C and D). (E) The result after predilatation. The
TM
Tr y to n
straddle the ostium of the SB (preferably 3/4 of this central transition zone should be in the SB and 1/4 in the
MB). The Tryton
artery was then easily rewired and the proximal MB zone of the Tryton
then advanced into the MB and deployed across the bifurcation (G and H). The SB was then rewired and final
kissing inflation performed. (I) The final angiographic result. IVUS performed at the carina confirmed good stent
expansion and ostial coverage (J).
stent was then positioned on the diagonal branch (F) utilizing the two central markers, which should
TM
was then deployed at nominal pressure and the SDS removed. The left anterior descending
Source
: Photos courtesy of Dr. Antonio Bartorelli.
TM
postdilated. A drug-eluting stent was
(
Continued on pages 242–244
)
(C)
(D) (E)
(F)
Figure 12 (
Continued
)
CURRENT STATUS AND FUTURE OF DEDICATED BIFURCATION STENT SYSTEMS
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(G)
243
(H)
(I)
Figure 12 (
Continued
)
244
LATIB ET AL.
(J)
Figure 12 (
conjunction with a standardDES in30 patients(31,32). TheTryton
Continued
The Tryton I FIM trial assessed the safety and performance of the TrytonTMSB stent in
)
TM
was successfully implanted
in all but 1 patient (96.7% angiographic success), and at 6-month follow-up, 3 (9.9%) patients
had experienceda MACE. There were two re-interventions at thebifurcation (TLR =6.6%), only
one of which was in the Tryton
TM
stent whereas the other was in the MB stent. Angiographic
follow-up was performed in 78% of patients and demonstrated a late loss of 0.17 ± 0.35 mm
and in-segment restenosis in one patient (4.3%) in the MB proximal to the stent. There are also
four other ongoing trials with Tryton
TM
: (a) Tryton II or IUVANT (Intravascular Ultrasound
Evaluation of Tryton Stent) study, a single-center IVUS study in 30 patients; (b) Tryton III, a
single-center OCT study in 15 patients; (c) Tryton IV, a multicenter left main coronary artery
feasibility study in 30 patients; and (d) E-Tryton 150 Registry, a multicenter registry to assess
the Tryton
Biguard
The Biguard
TM
in real-world patients.
TM
(Lepu Medical Ltd.)
TM
is also a SB specific stent (Fig. 13) designed specifically for coverage of ostial SB
disease while allowing the exchange of devices in the MB (33). The Biguard is a stainless-steel
sirolimus-eluting stent that has only three stent struts in the proximal segment that are 3 mm in
length and separated by 120 degrees. Thus the space between these three struts is large enough
to allow theadvancement of guidewires, balloons, or stents. The stent has three markers: two at
the proximal and distalpoints, and another oneat the intersectionsite providing SB positioning.
The stent is placed from the MB to SB with the middle marker positioned at the carina. The
Biguard
the culotte technique when stenting of both branches is required, similar to the Tryton
Axxess Plus
The Axxess Plus
TM
was thus designed to treat isolated ostial SB lesions (Medina 0.0.1) and to facilitate
TM
(Devax Inc)
TM
stent (Fig. 14) was the first of these dedicated bifurcation stents designed to
TM
.
elute an antirestenotic drug. It delivers Biolimus-A9, a sirolimus derivative, via a bio-erodable
polylactic acid (PLA) polymer carrier. The AxxessTMis a self-expanding, nickel-titanium
(Nitinol) alloy, conically shaped stent that is placed at the level of the carina. It has a rapidexchange delivery system with hydrophilic coating with controlled deployment upon withdrawal of acover sheath using the actuator. However, the Axxess
TM
stent may be limited bythe
CURRENT STATUS AND FUTURE OF DEDICATED BIFURCATION STENT SYSTEMS
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Figure 13 Lateral view of the Biguard stent demonstrating that there are only three strut strings (3 mm in length)
separated by every 120 degrees at its proximal segment. The middle marker (
the SB during positioning of the stent.
Source
: Adapted from Ref. 33.
arrow
) is aligned with the ostium of
245
fact that it needs to be precisely nested at the carina to be effective and in majority cases will
need another stent to fully treat the bifurcation.
Grube et al. have published the results of the prospective multicenter single-arm Axxess
Plus trial that enrolled 139 patients (34). The Axxess
TM
stent was successfully implanted in the
MB in 93.5% of cases with 80% of the patients receiving an additional stent to the MB or SB and
42% of patients requiring three stents to completely treat the bifurcation. Six of the 9 device
failures were due to improper alignment when the stent was placed distal or proximal to the
intended location. At six-month follow-up, the in-stent late loss was 0.09 ± 0.56 mm, in-stent
restenosis within the Axxess stent was 4.8% and the overall TLR rate was 7.5%. The Axxess
TM
AXXESS PLUS CONCEPT
Axxess stent is implanted first.
A successful implant will span the ostia of both branching vessels,
indicated by the presence of one marker in each branch vessel.
Stents for the branch vessels are selected to match the length and
diameter of the disease.
The Axxess distal markers provide a reference point to guide the
placement of distal stents.
(A)
Figure 14 Panel (A) shows a picture of an expanded Axxess
bifurcation stenting where three stents will be required to fully treat a severely diseased true bifurcation. (B and C)
A significant true bifurcation lesion (Medina type 1.1.1) involving the proximal left anterior descending artery and a
large first diagonal branch. Final angiographic result, in the left anterior oblique caudal (D) and in the right anterior
oblique cranial (E) views, after deployment of the Axxess
Cypher sirolimus-eluting stents (Cordis Corp, Johnson & Johnson, Warren, NJ), with the V-stenting technique, in
the two branches of the bifurcation. The three distal markers of the Axxess
branches of the bifurcation. “StentBoost Subtract” enhanced sequence view of the stented bifurcation in the right
anterior oblique cranial views (F).
Source
: Adapted from Ref. 40.
TM
stent and demonstrates the Axxess concept of
TM
stent in the proximal part of the bifurcation and two
TM
stent are clearly deep in the two
Continued on page 246
(
)
246
LATIB ET AL.
(B) (C)
(F)
(D) (E)
Figure 14 (
Continued
)
stent and Axxess technique of bifurcation stenting then underwent evaluation in the large
multicenter single-arm DIVERGE (Drug-Eluting Stent Intervention for Treating Side Branches
Effectively) Study that enrolled 302 patients with de novo coronary bifurcations (35). The
TM
Axxess
stent was deployed at the level of the carina followed by additional sirolimus-eluting
stents in the distal MB and/or SB. The primary endpoint was the nine-month rate of MACE,
CURRENT STATUS AND FUTURE OF DEDICATED BIFURCATION STENT SYSTEMS
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247
a composite of death, MI, and TLR. Primary device success was obtained in 297 (98.3%) of
302 patients and placement of the Axxess
laboratory in 93% of cases. In keeping with the Axxess concept, 88% of patients required an
additional stent to the Axxess
TM
: 67% in both branches, 17.7% in the distal MB, and 4% only
TM
in the SB. The cumulative nine-month MACE rate was 7.7%, including 0.7% death, 4.3% MI,
and 4.3% TLR. Subacute and late stent thrombosis occurred in 0.7% and 0.3% of patients.
In-bifurcation restenosis occurred in 9 (6.4%) of the 140 patients who underwent angiographic
follow-up. These low ratesof restenosis are certainly promisingfor this new bifurcation-specific
technology. Devax
the Axxess-LM
of the bifurcation. In the multicenter AXXENT (AXXESS Stent in Left Main Coronary Artery
Bifurcation Lesions) Trial, the safety and efficacy of the Axxess-LM
coronary artery was evaluated in 33 patients using a three stent technique of implanting the
Axxess-LM
circumflex arteries (36,37).At six-month follow-up, there was minimallate loss (0.01 ±0.34 mm)
and norestenosis in the Axxess
TM
have also developed a larger version of this self-expanding conical stent,
TM
stent that was designed to cover the left main coronary artery and ostium
TM
stent in the left main
TM
in the distal left main and two Cypher stents in the left anterior descending and
TM
stent, whereas the restenosis rate was6.9% for the leftanterior
descending artery and 16.1% for the circumflex artery. The overall TLR rate was 9.1% and there
were no cases of stent thrombosis in this small pilot study. An IVUS study on 26 patients of the
AXXENT trial demonstrated that Axxess
TM
stent in the LMCA showed enlargement during
the six-month follow-up, with a 12.4% increase in stent volume at follow-up compared with
postprocedure (p = 0.04) (36). Thus, once again confirming that chronic passive expansion
occurs with these self-expanding stents. The Axxess
TM
also resulted in significant neointimal
suppression with a percent neointimal volume obstruction of 3.0 ± 4.1%. It would also
appear that relatively inadequate stent expansion and greater neointimal formation may have
contributed to the luminal narrowing and higher restenosis rates at the left circumflex ostium.
REGULATORY CHALLENGES FACING DEDICATED BIFURCATION STENT SYSTEMS
A number of these devices are CE marked and commercially available in Europe, including at
the time of writing this chapter: Axxess
TM
Stentys
, and AntaresTM. However, none of these devices are FDA approved for use in the
TM
, Twin-RailTM, Nile CroCoTM, SideguardTM,TrytonTM,
United States. The FDA requirement for approval of any of these devices will most likely be an
adequately powered noninferiority trial compared to provisional SB stenting with superiority
of the dedicated device for procedural data. As for the dedicated stents that mandate stenting
of both branches, a superiority trial for angiographic outcomes will be essential.
CONCLUSION
Dedicated bifurcation stent systems are an exciting technology, as they are an attempt to find
specific technological solutions to a specific subset of coronary lesions. These devices have
undergone a rapid evolution from the pioneering dedicated stents that were bulky and impractical. The newer devices are rapidly changing with second- and third-generation devices entering the market and more clinical data becoming available. The new devices have a lower profile
but adequate lesion preparation remains vital to ensure their implantation success. There are
still a number of devices that require two wires to be delivered, and wire wrap and bias remain
important reasonsfor failure. Also there are some devices that have a poor placement tolerance,
or where accurate placement is vital to the success of the device. Many devices rely on passive
rotation for their accurate placement questioning their utility in highly complex lesions. Drugeluting versions have been an essential advancement for the future of many of these devices
whose first-generation bare-metal versions were hampered by high degrees of restenosis.
Given the innate variability of bifurcation anatomy, no single device will be utilizable
in all lesions, and a “family” of dedicated bifurcation stents may be required to optimally
treat highly variable bifurcation lesions. There is clearly a learning curve with all of these
devices, and the interventionalist will have to gain experience by performing a number of
implants that are proctored before optimal results and device success are achieved. However,
these innovative devices also carry many possible advantages including “decomplexifying”
bifurcationPCI byfacilitating boththe provisionaland double-stentingapproaches. Thepromise
of dedicated bifurcation devices is procedures that are less complex, with shorter procedural
248
LATIB ET AL.
times, less contrast usage, a lower risk of SB closure, and possibly improved angiographic and
clinical outcomes. However, before dedicated stents become approved, they will have to show
significant advantages over current techniques either with regard to procedural variables or
clinical outcomes-–this will require adequately powered randomized controlled trials.
ACKNOWLEDGMENTS
The authors would like to acknowledge the following persons for their invaluable assistance
in providing up-to-date clinical information, images, and/or clinical cases of these new dedicated bifurcation stents: Dr. P. Agostoni (The Netherlands), Dr. J. Ormiston (New Zealand),
Dr. R. Costa, and Dr. A. Abizaid (Brazil), Dr. R. Albiero (Italy), Dr. A. Bartorelli (Italy),
M. Secerov (Minvasys Inc), G. Ong (Trireme Medical Inc), O. Delporte (Tryton Inc), M. Paguin
and M. Gilmore (Cappella Inc), E. Ravanelli (Invatec), and P. Geudens (Stentys).
REFERENCES
1. Colombo A, Bramucci E, Sacca S, et al. Randomized study of the crush technique versus provisional
side-branch stenting in true coronary bifurcations: the CACTUS (Coronary Bifurcations: Application
of the Crushing Technique Using Sirolimus-Eluting Stents) Study. Circulation 2009; 119:71–78.
2. Colombo A, Moses JW, Morice MC, et al. Randomized study to evaluate sirolimus-eluting stents
implanted at coronary bifurcation lesions. Circulation 2004; 109:1244–1249.
3. Ferenc M, Gick M, Kienzle RP, et al. Randomized trial on routine vs. provisional T-stenting in the
treatment of de novo coronary bifurcation lesions. Eur Heart J 2008; 29:2859–2867.
4. Pan M, de Lezo JS, Medina A, et al. Rapamycin-eluting stents for the treatment of bifurcated coronary
lesions: a randomized comparison of a simple versus complex strategy. Am Heart J 2004; 148:857–864.
5. Steigen TK, Maeng M, Wiseth R, et al. Randomized study on simple versus complex stenting of
coronary artery bifurcation lesions: the Nordic bifurcation study. Circulation 2006; 114:1955–1961.
6. Latib A, Colombo A. Bifurcation disease: what do we know, what should we do? JACC Cardiovasc
Interv 2008; 1:218–226.
7. Latib A, Colombo A, Sangiorgi GM. Bifurcation stenting: current strategies and new devices. Heart
2009; 95:495–504.
8. Ormiston JA. Advanced3D Bench Imaging to EvaluateTreatmentApproaches for Bifurcation Lesions:
Focus onDedicated Bifurcation Stents. Presented atTranscatheterCardiovascular Therapeutics (TCT);
Washington, DC; October 2008. http://www.tctmd.com/show.aspx?id = 71156. Accessed August 28,
2009.
9. Leon M. Perspectives on dedicated bifurcation stent designs: needs assessment, classification of subcategories, and lessons learned from 3D bench imaging. Paper presented at: Third Annual Left Main
and Bifurcation Summit; June 5, 2009; New York. http://www.tctmd.com/show.aspx?id = 78864.
Accessed August 27, 2009.
10. Meredith I. The Medtronic Y-Stent: design specifications and clinical trial results. Paper presented at: Transcatheter Cardiovascular Therapeutics (TCT); September 21, 2009; San Francisco.
http://www.tctmd.com/txshow.aspx?tid =134&id = 83214&trid =2. Accessed October 2, 2009.
11. Solar RJ. The Y Med sideKicK
and ostial lesions. Paper presented at: Cardiovascular Revascularization Therapies (CRT); March 8,
2007; Washington, DC. http://www.crtonline.org/flash.aspx?PAGE
3, 2007.
12. Lefevre T, Ormiston J, Guagliumi G, et al. The Frontier stent registry: safety and feasibility of a
novel dedicated stent for the treatment of bifurcation coronary artery lesions. J Am Coll Cardiol 2005;
46:592–598.
13. Rizik DG. Abbott Pathfinder Stent: Transition to an everolimus-eluting platform and clinical plans.
Paper presented at: Transcatheter Cardiovascular Therapeutics (TCT); October 13, 2008; Washington,
DC. Available at: http://www.tctmd.com/show.aspx?id = 71156. Accessed August 28, 2009.
14. Lefevre T; on behalfof theDesire Investigators.Invatec Twin Rail Bifurcation Stent. Paper presented at:
Transcatheter Cardiovascular Therapeutics (TCT); 2005; Washington, DC. http://www.tctmd.com/
Show.aspx?id = 68990. Accessed July 22, 2008.
15. Albiero R. Invatec Twin-Rail Stent: Design Features and Clinical Updates. Paper presented at: Transcatheter Cardiovascular Therapeutics (TCT); October 13, 2008; Washington, DC. http://www.tctmd
.com/show.aspx?id = 71160. Accessed August 28, 2009.
16. Hoffman S. Der Twin Rail Stent in der Behandlung der Bifurkationsstenose: Ein neuer Ausweg aus
der Misere? Paper presented at: 72nd Annual Meeting of the German Cardiac Society in Mannheim;
April 20–22, 2006. Clin Res Cardiol 2006; 95:(suppl 5).
TM
Stent Delivery System for the treatment of coronary bifurcation
ID = 4328. Accessed December
CURRENT STATUS AND FUTURE OF DEDICATED BIFURCATION STENT SYSTEMS
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
249
17. Cervinka P, Bystron M, Spacek R, et al. Treatment of bifurcation lesions using dedicated bifurcation
stents versus classic bare-metal stents. Randomized, controlled trial with 12-month angiographic
follow up. J Invasive Cardiol 2008; 20:516–520.
18. Lefevre T, Pavlides G; on behalf of the Nile Registry investigators. Main Results of the Nile Registry.
http://www.bifurc.net/files/medtool/webmedtool/icpstool01/stud0112/html/Nile/frame.htm.
Accessed December 2, 2007.
19. Blanco BGD, Brenot P, Royer T, et al. Clinical and Procedural Evaluation of theNile Croco
R
Dedicated
Stent for Bifurcation—six-month clinical follow-up results of the nile croco registry. Interv Cardiol
2008; 3:46–50.http://www.touchcardiology.com/files/article
pdfs/dorado.pdf. AccessedSeptember
4, 2009.
20. Van Geuns R. The Minvasys Nile Paclitaxel-Eluting Sidebranch Access Stent: Results from the BiPAX
Study. Paper presented at: Third Annual Left Main and Bifurcation Summit; June 5, 2009; New York.
http://www.tctmd.com/show.aspx?id =78876. Accessed August 27, 2009.
21. Ikeno F, Kim YH,Luna J,et al. Acuteand long-term outcomes of thenovel side access (SLK-View)stent
for bifurcation coronary lesions: a multicenter nonrandomized feasibility study. Catheter Cardiovasc
Interv 2006; 67:198–206.
22. Laborde JC, Borenstein N, Behr L, et al. Stentys coronary bifurcation stent. Eurointervention 2007;
3:162–165.
23. Verheye S. First-In-Man study of the Stentys Coronary Bifurcation Stent fOr the Percutaneous treatmEnt of de-novo lesions in Native bifurcated coronary arteries: OPEN I Trial. Paper presented at:
Third Annual Left Main and Bifurcation Summit; June 5, 2009; New York. http://www.tctmd.com/
show.aspx?id = 78876. Accessed August 27, 2009.
24. Verheye S, Grube E, Ramcharitar S, et al. First-in-man (FIM) study of the Stentys bifurcation stent—
30 days results. EuroIntervention 2009; 4:566–571.
25. Ormiston JA, Webster M, El-Jack S, et al. The AST petal dedicated bifurcation stent: first-in-human
experience. Catheter Cardiovasc Interv 2007; 70:335–340.
26. Grube E. The BSC TAXUS Petal Sidebranch Access Stent: Results from the First Human Use Study.
Paper presented at: the Third Annual Left Main and Bifurcation Summit; June 5, 2009; New York.
http://www.tctmd.com/show.aspx?id =78872. Accessed August 27, 2009.
27. Costa RA, Abizaid A, Abizaid A, et al. Preliminary Results of the Novel TMI (TriReme Medical Inc.)
Antares Side Branch Adaptive System (Antares SAS
TM
Stent) for the Treatment of De Novo Coronary
Bifurcation Lesions—SCAI-ACCi2 Interventional E-Abstract2900–123. JAm CollCardiol 2008;51:B51.
28. Di Mario C. The Trireme Sidebranch Access Study: Results from the TOP FIM Study. Paper presented
at: Third Annual LeftMain andBifurcation Summit; June 5, 2009;New York. http://www.tctmd.com/
show.aspx?id = 78870. Accessed August 27, 2009.
29. Grube E, Wijns W, Schofer J, et al. FIM Results of Cappella Sideguard
TM
for Treatment of Coronary
Bifurcations. Paper presented at: Transcatheter Cardiovascular Therapeutics (TCT); October 21, 2007;
Washington, DC.
30. Grube E. The Cappella Sideguard
R
Coronary Sidebranch Stent. Paper presented at: Third Annual
Left Main and Bifurcation Summit; June 5, 2009; New York. http://www.tctmd.com/show.aspx?id =
78866. Accessed August 27, 2009.
31. Kaplan AV, Ramcharitar S, Louvard Y, et al. Tryton I, first-in-man (FIM) study: acute and 30 day
outcome. A preliminary report. Eurointervention 2007; 3:54–59.
32. Onuma Y, M¨ulle R, Ramcharitar S, et al. Tryton I, first-in-man (FIM) study: six month clinical outcome and angiographic outcome, analysis with new quantitative coronary angiography dedicated for
bifurcation lesions. Eurointervention 2008; 3:546–552.
33. Chen SL, Lv SZ, Kwan TW. Novel side branch ostial stent. J Interv Cardiol 2009; 22:145–149.
34. Grube E, Buellesfeld L, Neumann FJ, et al. Six-month clinical and angiographic results of a dedicated
drug-eluting stent for the treatment of coronary bifurcation narrowings. Am J Cardiol 2007; 99:1691–
1697.
35. Verheye S, Agostoni P, Dubois CL, et al. 9-month clinical, angiographic, and intravascular ultrasound
results of a prospective evaluation of the Axxess self-expanding biolimus A9-eluting stent in coronary bifurcation lesions: the DIVERGE (Drug-Eluting Stent Intervention for Treating Side Branches
Effectively) study. J Am Coll Cardiol 2009; 53:1031–1039.
36. Hasegawa T,Ako J, KooBK, et al. Analysis of left main coronaryartery bifurcation lesions treated with
biolimus-eluting DEVAX AXXESS plus nitinol self-expanding stent: intravascular ultrasound results
of the AXXENT trial. Catheter Cardiovasc Interv 2009; 73:34–41.
37. Verheye S. The Devax Biolimus-Eluting AXXESS Plus Stents: Design Variations and Clinical Results
fromAXXESS PLUS,DIVERGE andAXXENT ClinicalTrials.Paper presentedat: TranscatheterCardiovascular Therapeutics (TCT); October 2008; Washington, DC. http://www.tctmd.com/show.aspx?id
= 71178. Accessed August 28, 2009.
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