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Iorio R, Cereda A, Vecchia A, Romagnoli E, Cioffi P, Chiricolo G, Sangiorgi G. Provisional stenting or not provisional stenting: seven critical points for bifurcations treatment with a glimpse on left main bifurcation stenting. Minerva Cardiol Angiol 2020; 69:322-330. [PMID: 32996303 DOI: 10.23736/s2724-5683.20.05294-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Stenting of coronary bifurcation lesions represents a challenge for the interventional cardiologist. A bifurcation lesion could be treated with several techniques. Therefore, it is of paramount importance to decide the strategical approach at the beginning of the procedure evaluating the patient's bifurcation anatomy, the angle between main and side branch, plaque burden at the level of the carina, and size of the side branch. Although it is clear that all bifurcation's treatment techniques have each one their advantages and disadvantages, provisional stenting remains the gold-standard technique, because it leaves the possibility to switch to other technical solutions with optimal angiographic and long-term clinical results. In this review, different tips and tricks for left main and bifurcation stenting are debated.
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Affiliation(s)
- Riccardo Iorio
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy
| | - Alberto Cereda
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy
| | - Augustin Vecchia
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy
| | - Enrico Romagnoli
- Department of Cardiology, Cardiac Cath Lab, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Paolo Cioffi
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy.,Department of Cardiology, Cardiac Cath Lab, Città di Alessandria Institute, Alessandria, Italy
| | - Gaetano Chiricolo
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Giuseppe Sangiorgi
- Cardiothoracic Department, Cardiac Cath Lab, San Gaudenzio Institute, University of Eastern Piedmont, Novara, Italy - .,Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
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