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Optimal Strategy for Provisional Side Branch Intervention in Coronary Bifurcation Lesions: 3-Year Outcomes of the SMART-STRATEGY Randomized Trial New Volumetric Analysis Method for Stent Expansion and its Correlation With Final Fractional Flow Reserve and Clinical Outcome An ILUMIEN I Substudy Identification of High-Risk Plaques Destined to Cause Acute Coronary Syndrome Using Coronary Computed Tomographic Angiography and Computational Fluid Dynamics Double-Kiss-Crush Bifurcation Stenting: Step-by-Step Troubleshooting Chronic thromboembolic pulmonary hypertension The EBC TWO Study (European Bifurcation Coronary TWO): A Randomized Comparison of Provisional T-Stenting Versus a Systematic 2 Stent Culotte Strategy in Large Caliber True Bifurcations Difference in basic concept of coronary bifurcation intervention between Korea and Japan. Insight from questionnaire in experts of Korean and Japanese bifurcation clubs Percutaneous Coronary Intervention Techniques for Bifurcation Disease: Network Meta-analysis Reveals Superiority of Double-Kissing Crush Robustness of Fractional Flow Reserve for Lesion Assessment in Non-Infarct-Related Arteries of Patients With Myocardial Infarction 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

Expert Opinion2015;11 Suppl V:V99-101.

JOURNAL:EuroIntervention. Article Link

Technical aspects of the culotte technique

Erglis A, Lassen JF, Di Mario C. Keywords: culotte technique; bifurcaiton stenting; shortcoming

ABSTRACT

The culotte technique provides near perfect coverage of the carina and side branch ostium at the expense of an excess of metal covering the proximal end. It can be used in almost all true bifurcation lesions, but should be avoided in bifurcations when there is a large mismatch between the proximal main branch and the side branch diameters. The main disadvantage of this technique is that rewiring of both branches through the stent struts is required, which can be difficult, technically demanding, and time-consuming.