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Review
. 2004 Jun;90(6):713-22.
doi: 10.1136/hrt.2002.007682.

Percutaneous coronary intervention for bifurcation coronary disease

Yves Louvard  1 , Thierry Lefèvre, Marie-Claude Morice
Affiliations
Review

Percutaneous coronary intervention for bifurcation coronary disease

Yves Louvard et al. Heart. 2004 Jun.
No abstract available

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Figures

Figure 1
Figure 1
Classification of treatment. (1) and (2): Classic T stenting beginning with side branch stenting. (3): “Modified T stenting”. (4): “Crush” technique. (5): Classic T stenting beginning with main branch stenting. (6): Provisional T stenting. (7): “Culotte” or “trousers” technique. (8): “Touching stents” completed or not as Y technique. (9). “Trouser legs and seat” technique, a classic “touching stents” technique completed proximally by a “skirt” technique. (10): “Kissing stents” technique. (11): “Skirt” technique.
Figure 2
Figure 2
Main branch stent deformation during type B treatment. (A) Biocompatible stent deployed in main branch. (B) After balloon inflation toward the side branch: the ostium of the side branch is stented, the opposite struts of the stent are attracted towards the middle of the main branch lumen. (C) Correction of deformation by kissing balloon inflation. (D) The same figure is observed in a left anterior descending (LAD)-diagonal bifurcation.
Figure 3
Figure 3
Relation between ostium circumference and angulation of the bifurcation.
Figure 4
Figure 4
Institut Cardiovasculaire Paris Sud (ICPS) classification of bifurcation lesions.
Figure 5
Figure 5
(1) Left anterior descending (LAD)/diagonal type 2 bifurcation lesion. (2) The distal LAD is stented first at the ostium. (3) The stent is slightly protruding in the diagonal ostium. (A) Balloon inflation in the diagonal. (4) After LAD to diagonal stenting, plaque shifting has occurred inside the LAD stent. (5) Kissing balloon inflation. (6) Final result with a residual stenosis in mid LAD ostium. (B) No gap in the T stenting.
Figure 6
Figure 6
(1) “Culotte” technique in the bench (Crossflex stent). (2) Final result of a “culotte” technique in a LAD/diagonal bifurcation (Crossflex stent): the excess of metal is not visible.
Figure 7
Figure 7
(1) Type 3 LAD/diagonal bifurcation lesion. (2) After stenting the LAD across the diagonal branch with a jailed wire in the diagonal artery; the diagonal artery ostium is pulled up by the stent and the jailed wire.
See this image and copyright information in PMC

References

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