Provisional bifurcation stenting

Abstract

Obstructive coronary lesions involving a branch origin or extending into the branch itself, remain one of the main challenges in the rapidly developing world of interventional cardiology. Acutely, these lesions are prone to the complications resulting in significant residual stenosis or loss of one of the branches. Long-term follow up has also been disappointing with a high incidence of restenosis. Numerous techniques have been developed, aimed at optimizing the acute and long-term results by adapting standard angioplasty hardware, with limited success, particularly in the long term. This article describes a fully dedicated system for bifurcation lesions with stenting of the main vessel to the main branch, yet ensuring side branch patency, with limited risk of branch origin stenosis or stent jailing, allowing for provisional stenting of the branch as dictated by the angiographic outcome.