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Percutaneous Coronary Intervention Using Drug-Eluting Stents Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Stenosis: A Meta-Analysis of Randomized Trials New-onset atrial fibrillation after PCI and CABG for left main disease: insights from the EXCEL trial and additional studies Surgical ineligibility and mortality among patients with unprotected left main or multivessel coronary artery disease undergoing percutaneous coronary intervention Impact of coronary anatomy and stenting technique on long-term outcome after drug-eluting stent implantation for unprotected left main coronary artery disease Contemporary Use and Trends in Unprotected Left Main Coronary Artery Percutaneous Coronary Intervention in the United States: An Analysis of the National Cardiovascular Data Registry Research to Practice Initiative Differences between the left main and other bifurcations EXCELling in Left Main Intervention Comparative effectiveness analysis of percutaneous coronary intervention versus coronary artery bypass grafting in patients with chronic kidney disease and unprotected left main coronary artery disease Clinical and angiographic outcomes of patients treated with everolimus-eluting stents or first-generation Paclitaxel-eluting stents for unprotected left main disease Percutaneous Coronary Intervention of Left Main Disease: Pre- and Post-EXCEL (Evaluation of XIENCE Everolimus Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) and NOBLE (Nordic-Baltic-British Left Main Revascularization Study) Era

Clinical Case Study2018 Feb 2;13(15):e1812-e1813.

JOURNAL:EuroIntervention. Article Link

Influence of the sequence of proximal optimisation technique and side branch dilation for the opening of jailed struts after coronary bifurcation stenting

Murasato Y, Mori T, Okamura T et al. Keywords: proximal optimisation technique; side branch dilation; jailed struts; coronary bifurcation stenting

ABSTRACT


A 67-year-old man with a 1,1,0 lesion in the left circumflex artery obtuse marginal branch bifurcation (Panel Aa), in which vessel references in the proximal, distal MV and SB were 3.2, 2.6, and 2.8 mm, respectively, underwent zotarolimus-eluting 2.75×12 mm stent (Medtronic, Minneapolis, MN, USA) implantation at 8 atm (Panel Ab). POT was performed with the stent delivery balloon at 12 atm with its distal marker located in the carina to ensure that the stent was well apposed (Panel Ac). A 2.5×4 mm Glider PTCA balloon (TriReme, Pleasanton, CA, USA) was subsequently dilated in the SB ostium (Panel Ad). The procedure was guided with two-dimensional (2D) OCT (St. Jude Medical, St. Paul, MN, USA) and the data were sent to another hospital for 3D reconstruction using dedicated software (INTAGE Realia; CYBERNET, Tokyo, Japan). The 3D image demonstrated GWR into the proximal cell (Panel Ba); however, the protruded struts were folded towards the distal SB after SB dilation (Panel Bb-Bd, Moving image 1, Moving image 2).