The potential clinical utility of intravascular ultrasound guidance in patients undergoing percutaneous coronary intervention with drug-eluting stents

2008 ◽  
Vol 9 (3) ◽  
pp. 193
Author(s):  
P. Roy ◽  
T. Okabe ◽  
T.L. Pinto Slottow ◽  
D.H. Steinberg ◽  
K. Kaneshige ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Intravascular Ultrasound ◽  
Clinical Utility ◽  
Ultrasound Guidance ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Potential Clinical Utility

Percutaneous Coronary Intervention for Complex Bifurcation Lesions

2010 ◽  
Vol 5 (1) ◽  
pp. 58
Author(s):  
Yves Louvard ◽  
Morice Marie-Claude ◽  
Thomas Hovasse ◽  
Thierry Lefèvre ◽  
◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Side Branch ◽  
Drug Eluting Stents ◽  
Open Angle ◽  
Balloon Inflation ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Bifurcation Lesions ◽  
Stent Diameter

Coronary bifurcations are prone to the development of atherosclerosis. They pose technical difficulties for angioplasty treatment and are a predictor of stent thrombosis and restenosis. Treatment of coronary bifurcations is still subject to debate, especially when the side branch (SB) is large, not easily accessible and narrowed by a long lesion. There is currently no indexed treatment for this type of lesion (Medina classification), as the strategy of provisional SB stenting with drug-eluting stents (DES) has proved to be equally efficient as the dualstent technique. Complex techniques are associated with poor outcome in certain lesion types, such as T-stenting when the angle between the two distal branches is small or the crush and culotte technique in the presence of an open angle. Provisional SB stenting may be used when primary dual stenting is required, with a low risk of failure provided that the following guidelines are implemented: stenting of the main branch through the protected SB with a stent diameter adapted to the distal main branch, immediate optimisation of the proximal stent segment (Finet’s law), guidewire exchange, kissing balloon inflation with non-compliant balloons selected according to the diameter of the distal branches and T-stenting of the SB before final kissing inflation.

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