The International Journal of Cardiovascular Imaging

, Volume 30, Issue 8, pp 1445–1456 | Cite as

Side branch healing patterns of the Tryton dedicated bifurcation stent: a 1-year optical coherence tomography follow-up study

  • Maik J. Grundeken
  • Hector M. Garcia-Garcia
  • Robin P. Kraak
  • P. Woudstra
  • Daniel M. de Bruin
  • Ton G. van Leeuwen
  • Karel T. Koch
  • Jan G. Tijssen
  • Robbert J. de Winter
  • Joanna J. Wykrzykowska
Original Paper


The bare-metal Tryton Side Branch (SB) Stent™ (Tryton Medical, Durham, NC, USA) is used with a drug-eluting stent (DES) in the main branch (MB) to treat bifurcation lesions. It is argued that a drug-eluting Tryton-version is needed to improve clinical outcomes, although previous registries have shown good clinical results. More insights in neo-intimal hyperplasia (NIH) growth patterns of the Tryton treatment strategy are needed to decide if and where to drug-coat the stent. Ten patients returned for follow-up angiography (mean follow-up time 393 ± 103 days) and optical coherence tomography (OCT) pullbacks from the MB were obtained in all patients and from the SB in six patients. A per-strut analysis showed an uncovered strut rate of 0.7 % and an incompletely-apposed strut rate of 0.8 %. Most incompletely-apposed struts were found at the bifurcation region, in the luminal half facing towards the SB. Mean NIH thickness in the proximal MB, distal MB and SB were 0.14 ± 0.11, 0.19 ± 0.11, and 0.34 ± 0.19 mm, respectively, with a variety of growth patterns observed in the SB. We found good vascular healing of the DES in the MB, while healing was less favourably in the SB part. Furthermore, we observed a variety of NIH growth patterns in this SB part and more studies are needed to investigate the relation between growth patterns and clinical outcomes.


Coronary artery disease Percutaneous coronary intervention Coronary bifurcation lesion Bifurcation lesion Bifurcation stent Tryton stent Optical coherence tomography Three-dimensional optical coherence tomography 


Conflict of interest

Maik Grundeken and Joanna Wykrzykowska receive consultancy fees from Tryton Medical. None of the other authors declared any relevant conflict of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Maik J. Grundeken
    • 1
  • Hector M. Garcia-Garcia
    • 2
  • Robin P. Kraak
    • 1
  • P. Woudstra
    • 1
  • Daniel M. de Bruin
    • 3
  • Ton G. van Leeuwen
    • 1
  • Karel T. Koch
    • 1
  • Jan G. Tijssen
    • 1
  • Robbert J. de Winter
    • 1
  • Joanna J. Wykrzykowska
    • 1
  1. 1.Department of Cardiology, The Heart Center, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.The Thorax Center, Erasmus Medical CenterErasmus University RotterdamRotterdamThe Netherlands
  3. 3.Department of Biomedical Engineering and Physics, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands

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