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Bifurcation Stenting

Abstract

Recommended Article

Active SB-P Versus Conventional Approach to the Protection of High-Risk Side Branches: The CIT-RESOLVE Trial Percutaneous Coronary Intervention Techniques for Bifurcation Disease: Network Meta-analysis Reveals Superiority of Double-Kissing Crush 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 Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions Percutaneous coronary intervention for coronary bifurcation disease: 11th consensus document from the European Bifurcation Club Usefulness of longitudinal reconstructed optical coherence tomography images for predicting the need for the reverse wire technique during coronary bifurcation interventions Long-Term Clinical Outcomes of Final Kissing Ballooning in Coronary Bifurcation Lesions Treated With the 1-Stent Technique: Results From the COBIS II Registry (Korean Coronary Bifurcation Stenting Registry) 3-Year Outcomes After 2-Stent With Provisional Stenting for Complex Bifurcation Lesions Defined by DEFINITION Criteria
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Review Article2018 Oct;16(10):725-734.

JOURNAL：Expert Rev Cardiovasc Ther. Article Link

Contemporary techniques in percutaneous coronary intervention for bifurcation lesions

Collet C, Mizukami T, Grundeken MJ. Keywords: Birfurcation; PCI; bench testing; provisional; two-stent techniques

ABSTRACT

Treatment of coronary bifurcation lesions with contemporary state-of-the-art percutaneous coronary intervention (PCI) is still associated with higher rate of adverse cardiovascular events compared to non-bifurcation lesions. Bench testing and virtual computer modeling have increased our understanding of bifurcation PCI guiding refinement in bifurcation techniques. New insights on bifurcation PCI have the potential to further improve clinical outcomes in patients presenting with bifurcation lesions. Areas covered: The present manuscript aims to review the methods for bifurcation lesion assessment and treatment strategy step by step supported on bench and clinical evidence. Expert commentary: Invasive pressure-wire evaluation is essential to determine the appropriateness of bifurcation PCI, particularly in intermediate coronary stenosis. Treatment strategy relies on four parameters: diameters of the three segments of the bifurcation; lesion length and plaque distribution; and bifurcation angle. The optimal technique for bifurcation PCI is still debated, an individualized approach with an initial provisional side branch stenting strategy seems to be suitable in the 75 to 95% of patients. For more complex bifurcations, two-stent techniques may be required with increasing evidence supporting the usefulness of the double kissing balloon crush (DK-crush) technique.
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