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