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Intravascular ultrasound in the evaluation and treatment of left main coronary artery disease: a consensus statement from the European Bifurcation Club Safety of intermediate left main stenosis revascularization deferral based on fractional flow reserve and intravascular ultrasound: A systematic review and meta-regression including 908 deferred left main stenosis from 12 studies Percutaneous coronary intervention in left main coronary artery disease: the 13th consensus document from the European Bifurcation Club Optimizing outcomes during left main percutaneous coronary intervention with intravascular ultrasound and fractional flow reserve: the current state of evidence A randomized clinical study comparing double kissing crush with provisional stenting for treatment of coronary bifurcation lesions: results from the DKCRUSH-II (Double Kissing Crush versus Provisional Stenting Technique for Treatment of Coronary Bifurcation Lesions) trial Percutaneous coronary intervention with drug-eluting stents versus coronary artery bypass grafting in left main coronary artery disease: an individual patient data meta-analysis Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis. The PRECOMBAT-2 (Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease) study Radial versus femoral artery access in patients undergoing PCI for left main coronary artery disease: analysis from the EXCEL trial Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease Incidence and Management of Restenosis After Treatment of Unprotected Left Main Disease With Second-Generation Drug-Eluting Stents (from Failure in Left Main Study With 2nd Generation Stents-Cardiogroup III Study)

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).