If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account. If the address matches an existing account you will receive an email with instructions to retrieve your username. Catheterization and Cardiovascular Interventions Volume 65, Issue 1. Coronary Artery Disease. Samin K. Read the full text. Tools Request permission Export citation Add to favorites Track citation. Share Give access Share full text access. Share full text access. Please review our Terms and Conditions of Use and check box below to share full-text version of article.
POT is also beneficial to facilitate the cross of wire and balloon after MV stenting. It should cover the proximal edge of stent carina, which can be done by aligning the proximal edge of distal balloon marker with the tip of stent carina Figure 4. The clinical impact of this new technique should be tested in the clinical trial. B Correct positioning of a post-dilating balloon, aligning the proximal edge of distal balloon marker with the tip of stent carina. C Post-dilation. D MV stent is expanded after post-dilation.
Current consensus is that the provisional approach is the standard strategy for the most of coronary bifurcation stenting.
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The indication of SB treatment, however, is not clear in the provisional approach. Target vessel failure TVF , the primary endpoint was similar between 2 groups 9. Interestingly, TLR was numerically higher 7. As a conclusion, the indication of SB stenting is better to be conservative. Most of bifurcation lesion can be treated with the provisional approach, but still we have some cases we have to consider 2-stent technique.
There have several trials to find the best elective 2-stent techniques, but the results are quite variable. Maybe the optimal result especially in term of stent expansion is much more important than the selection of a specific 2-stent technique. Currently most popular techniques are T-stent and small protrusion, mini-crush technique, mini-culotte technique, and DK-crush technique. I prefer T-stenting and small protrusion technique, because it is simple, provisional in nature, and above all the most familiar to me. Even after so many studies, still we have more questions than answers.
We do not know whether the elective 2-stenting is better with next generation DES. We do not know the future roles of dedicated bifurcation stent and fully bioresorbable scaffold in the bifurcation lesion. The best clinical come is the most important goal of coronary bifurcation stenting. Good question and persistent study will make it happen. Conflict of Interest: The author has no financial conflicts of interest. National Center for Biotechnology Information , U.
Journal List Korean Circ J v. Korean Circ J. Published online Apr Find articles by Hyeon-Cheol Gwon. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Mar 19; Accepted Apr 4. The Korean Society of Cardiology.
Abstract Coronary bifurcation stenting is still complex and associated with a high risk of stent thrombosis and restenosis even with contemporary techniques. Keywords: Bifurcation lesion, Stents, Percutaneous coronary intervention. Open in a separate window. Figure 1. Various nomenclature systems of bifurcation lesion.
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Figure 2. Plaque shift and carina shift The occlusion of SB after MV stenting is one of the most common complications during bifurcation stenting. How to prevent SB occlusion The risk of SB occlusion during the procedure is the major cause of the complexity of coronary bifurcation stenting.
Figure 3. Figure 4. Indication of SB stenting in the provisional approach Current consensus is that the provisional approach is the standard strategy for the most of coronary bifurcation stenting. What is the best 2-stent technique?
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Footnotes Conflict of Interest: The author has no financial conflicts of interest. Data curation: Gwon HC. Formal analysis: Gwon HC. Investigation: Gwon HC. Methodology: Gwon HC. Supervision: Gwon HC. Validation: Gwon HC. Writing - original draft: Gwon HC. References 1. J Am Coll Cardiol. Restenosis rates following bifurcation stenting with sirolimus-eluting stents for de novo narrowings.
Am J Cardiol. Clinical and angiographic outcome after implantation of drug-eluting stents in bifurcation lesions with the crush stent technique: importance of final kissing balloon post-dilation. Long-term outcomes of provisional stenting compared with a two-stent strategy for bifurcation lesions: a meta-analysis of randomized trials. Simple or complex stenting for bifurcation coronary lesions: a patient-level pooled-analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study.
Circ Cardiovasc Interv. Colombo A, Jabbour RJ. Bifurcation lesions: no need to implant two stents when one is sufficient! Eur Heart J. Serruys PW.
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The treatment of coronary bifurcations: a true art form. Volume 65 , Issue 1 May Pages Related Information. Close Figure Viewer. Browse All Figures Return to Figure. Previous Figure Next Figure. Email or Customer ID. Forgot password? Old Password. New Password. Password Changed Successfully Your password has been changed.