Feasibility and short-term outcomes of bioadaptor in bifurcation intervention using culotte technique: intravascular ultrasound analysis from a single-center experience
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 (IVUS). 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, proximal optimization technique, rewiring, and final kissing balloon inflation, with IVUS used to assess bioadaptor expansion, apposition, and structural integrity. Technical and procedural success was achieved in all patients (100%), with successful rewiring through bioadaptor struts in all attempts (26 of 26, 100%). IVUS demonstrated satisfactory expansion: main branch ostial expansion 94.9% ± 10.6%, side branch ostial expansion 90.2% ± 17.5%, and proximal expansion ratio 0.95 ± 0.16. No strut fractures or malapposition occurred. Early experience with bioadaptor implantation in culotte bifurcation stenting demonstrates feasibility, with favorable acute IVUS findings in selected patients.