TCT-697 Provisional Side Branch Stenting for 1.1.1 Distal Left Main Percutaneous Coronary Intervention

Percutaneous coronary intervention for left main trifurcation disease is challenging. Although side branch protection techniques such as the jailed balloon technique and jailed Corsair technique are the established methods for treatment of coronary bifurcation lesions, little is known regarding the application and feasibility of these techniques for left main trifurcation disease. We herein describe a 72-year-old man with angina pectoris who was successfully treated with percutaneous coronary stent implantation for a left main trifurcation lesion. In this case, we performed a novel double side branch protection technique, the simultaneous jailed balloon and jailed Corsair technique, with a single 8 Fr guiding catheter. This is the first case report to highlight the feasibility and efficacy of combined use of the jailed balloon and jailed Corsair techniques during percutaneous coronary intervention for left main trifurcation disease.

Download Full-text

Unprotected Left Main Coronary Artery Percutaneous Coronary Intervention-Our Experiences at a Tertiary Hospital

Cardiovascular Journal ◽

10.3329/cardio.v6i2.18349 ◽

2014 ◽

Vol 6 (2) ◽

pp. 107-111

Author(s):

S Munwar ◽

AHMW Islam ◽

S Talukder ◽

AQM Reza ◽

T Ahmed ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Left Main Coronary Artery ◽

Coronary Intervention ◽

Drug Eluting Stent ◽

Bare Metal ◽

Coronary Artery Diseases ◽

Left Main ◽

Percutaneous Coronary ◽

Drug Eluting

Background: Aim of the study was to evaluate the primary procedural success of percutaneous coronary intervention of unprotected left main coronary artery stenosis using either Bare-metal stents or drug eluting stent. Methods: Total 33 patients were enrolled in this very preliminary non-randomized prospective cohort study. Among them, Male: 25 and Female: 8. Total 35 stents were deployed. Mean age were for Male: 59 yrs, for Female: 62 yrs. Associated coronary artery diseases risk factors were dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive family history for coronary artery diseases and smoking. Results: Among the study group; 26 (78%) were Dyslipidemic, 24(70%) were hypertensive; 17 (51.5%) patients were Diabetic, 11(33%) were smoker and 7(21%) patients had family history of Ischaemic heart disease. Female patients were more obese (BMI M 26: F 27) and developed coronary artery diseases in advance age. Common stented territory were left main: 20 (60%), Left main to left anterior descending artery 7 (22%) and Left main to left circumflex artery 6 (18%). Average length and diameter of stent was 3.5 and 18 mm respectively. Stent used: Bare Metal Stent 5 (15%), Drug Eluting Stent: 28 (85%). Among the different Drug Eluting Stents, Everolimus eluting stents were 11 (39.3%), Sirolimus eluting 10(35.7%), Paclitaxel eluting 3 (10.7%), Biolimus eluting 3 (10.7%) and Zotarolimus eluting1 (3.6%). In the present study, overall survival outcome was 94% (31 patient), mortality of cardiac cause 3% (1 patient) and 1 patient (3%) died of hepatocellular carcinoma. Conclusion: Our study has shown that percutaneous coronary intervention of the unprotected left main is a safe and effective alternative to Coronary Artery Bypass Graft (CABG). DOI: http://dx.doi.org/10.3329/cardio.v6i2.18349 Cardiovasc. j. 2014; 6(2): 107-111

Download Full-text

Use of Intravascular Ultrasound Imaging in Percutaneous Coronary Intervention on Left Main Coronary Artery Disease

10.15420/rc.2017.m004 ◽

2017 ◽

Author(s):

Adrian P Banning ◽

◽

Giovanni Luigi De Maria ◽

Keyword(s):

Coronary Artery Disease ◽

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Left Main Coronary Artery ◽

Coronary Intervention ◽

Left Main ◽

Intravascular Ultrasound Imaging ◽

Main Coronary Artery Disease ◽

Percutaneous Coronary ◽

Artery Disease

Download Full-text

Percutaneous Coronary Intervention for Complex Bifurcation Lesions

Interventional Cardiology Review ◽

10.15420/icr.2010.5.1.58 ◽

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.

Download Full-text