Minerva Cardioangiologica 2020 Sep 30

DOI: 10.23736/S0026-4725.20.05294-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Provisional stenting or not provisional stenting: seven critical points for bifurcations treatment with a glimpse on LM bifurcation stenting

Riccardo IORIO ¹, Alberto CEREDA ¹, Augustin VECCHIA ¹, Enrico ROMAGNOLI ², Paolo CIOFFI ^{1, 3}, Gaetano CHIRICOLO ⁴, Giuseppe SANGIORGI ^{1, 4} ✉

¹ Cardiac Cath Lab, Cardiothoracic Department Piemonte Orientale, San Gaudenzio Institute, Novara, Italy; ² Cardiac Cath Lab, Department of Cardiology, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy; ³ Cardiac Cath Lab, Department of Cardiology, Città di Alessandria Insitute, Alessandria, Italy; ⁴ Department of Systemic Medicine, University of Rome Tor Vergata, Rome, Italy

Stenting of coronary bifurcation lesions represents a challenge for the interventional cardiologist. A bifurcation lesion could be treated with several techniques. Therefore, it is of paramount importance to decide the strategical approach at the beginning of the procedure evaluating the patient’s bifurcation anatomy, the angle between main and side branch, plaque burden at the level of the carina, and size of the side branch. Although it is clear that all bifurcation’s treatment techniques have each one their advantages and disadvantages, provisional stenting remains the gold-standard technique, because it leaves the possibility to switch to other technical solutions with optimal angiographic and long-term clinical results. In this mini-review, different tips and tricks for LM and bifurcation stenting are debated.

KEY WORDS: Bifurcation stenting; Provisional stenting; Double kissing crush stenting; Proximal optimization technique; Kissing balloon inflation