Imaging Comparisons Between Bifurcation Stenting Procedures Performed in Human Patients and Those Within Reanimated Swine Hearts.
6 affiliations
- 1Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
- 2Interventional Cardiology Unit, ARNAS Civico Di Cristina Benfratelli, Palermo, Italy.
- 3Visible Heart® Laboratories, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
- 4Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.
- 5Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.
- 6Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: [email protected].
Abstract
Background
Reanimated swine hearts have been used for over a decade to study bifurcation percutaneous coronary intervention, on the assumption that their results resemble those in patients, which has rarely been tested directly.Objectives
The objective of the study was to test how closely provisional bifurcation procedures performed in reanimated swine hearts agree with the human stent-geometry result of a given technique.Methods
We pooled individual-case data from 2 randomized (1:1) trials sharing 1 protocol, comparing proximal optimization technique (POT)/kissing/POT and POT/side/POT (PSP) in 30 percutaneous coronary interventions in 17 reanimated swine hearts and 60 patients. Stent geometry was assessed across ten endpoints in 4 subsegments by human-optical coherence tomography (OCT), swine-OCT, and micro-computed tomography (CT) of the explanted swine stents.Results
Swine-OCT agreed with micro-CT at the distal main vessel (concordance correlation coefficient 0.83). The technique effect agreed in direction at 8 of 10 endpoints; the descriptive calibration slope was 1.04 (indistinguishable from unity), although the case-level bootstrap was imprecise (slope 0.88; 95% CI: 0.47-1.54). Distal main-vessel expansion was lowest with PSP (mean 91% vs 98% in swine; 84% vs 99% in patients); major malappositions were rare after POT/kissing/POT but affected about half of PSP cases in both species. OCT matched micro-CT for expansion but not eccentricity; underexpansions extended farther along the larger human vessel.Conclusions
A reanimated swine-heart model showed close concordance with the human geometric result of bifurcation techniques, matching the direction at 8 of 10 endpoints and, approximately, the magnitude. This is descriptive concordance, not proven predictive equivalence, and supports the model as a preclinical screening tool pending prospective validation.
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BibTeX
@article{bianchini2026imaging,
title = {{Imaging Comparisons Between Bifurcation Stenting Procedures Performed in Human Patients and Those Within Reanimated Swine Hearts.}},
author = {Francesco Bianchini and Enrico Romagnoli and Cristina Aurigemma and Mattia Lunardi and Lazzaro Paraggio and Stefano Cangemi and Amanda DeVos and Fabio Casamassima and Giuseppe Saglioccolo and Emiliano Bianchini and Carlo Trani and Francesco Burzotta and Paul Anthony Iaizzo},
journal = {JACC. Advances},
year = {2026},
month = oct,
doi = {10.1016/j.jacadv.2026.103292},
url = {https://europepmc.org/article/MED/42832924},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Imaging Comparisons Between Bifurcation Stenting Procedures Performed in Human Patients and Those Within Reanimated Swine Hearts.
AU - Francesco Bianchini
AU - Enrico Romagnoli
AU - Cristina Aurigemma
AU - Mattia Lunardi
AU - Lazzaro Paraggio
AU - Stefano Cangemi
AU - Amanda DeVos
AU - Fabio Casamassima
AU - Giuseppe Saglioccolo
AU - Emiliano Bianchini
AU - Carlo Trani
AU - Francesco Burzotta
AU - Paul Anthony Iaizzo
PY - 2026
DA - 2026/10/05
JO - JACC. Advances
DO - 10.1016/j.jacadv.2026.103292
UR - https://europepmc.org/article/MED/42832924
AB - Background Reanimated swine hearts have been used for over a decade to study bifurcation percutaneous coronary intervention, on the assumption that their results resemble those in patients, which has rarely been tested directly.Objectives The objective of the study was to test how closely provisional bifurcation procedures performed in reanimated swine hearts agree with the human stent-geometry result of a given technique.Methods We pooled individual-case data from 2 randomized (1:1) trials sharing 1 protocol, comparing proximal optimization technique (POT)/kissing/POT and POT/side/POT (PSP) in 30 percutaneous coronary interventions in 17 reanimated swine hearts and 60 patients. Stent geometry was assessed across ten endpoints in 4 subsegments by human-optical coherence tomography (OCT), swine-OCT, and micro-computed tomography (CT) of the explanted swine stents.Results Swine-OCT agreed with micro-CT at the distal main vessel (concordance correlation coefficient 0.83). The technique effect agreed in direction at 8 of 10 endpoints; the descriptive calibration slope was 1.04 (indistinguishable from unity), although the case-level bootstrap was imprecise (slope 0.88; 95% CI: 0.47-1.54). Distal main-vessel expansion was lowest with PSP (mean 91% vs 98% in swine; 84% vs 99% in patients); major malappositions were rare after POT/kissing/POT but affected about half of PSP cases in both species. OCT matched micro-CT for expansion but not eccentricity; underexpansions extended farther along the larger human vessel.Conclusions A reanimated swine-heart model showed close concordance with the human geometric result of bifurcation techniques, matching the direction at 8 of 10 endpoints and, approximately, the magnitude. This is descriptive concordance, not proven predictive equivalence, and supports the model as a preclinical screening tool pending prospective validation.
SN - 2772-963X
ER -