The culotte technique provides near perfect coverage of the carina and
side branch ostium at the expense of an excess of metal covering the
proximal end. It can be used in almost all true bifurcation lesions, but
should be avoided in bifurcations when there is a large mismatch
between the proximal main branch and the side branch diameters. The main
disadvantage of this technique is that rewiring of both branches
through the stent struts is required, which can be difficult,
technically demanding, and time-consuming.
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