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Bifurcations - What Have we Learned from Randomised Trials?
Author(s): Leif Thuesen , Niels Ramsing Holm Added: 3 years ago
Bifurcation lesions are frequent and account for about 15 % of all percutaneous coronary intervention cases.1 Bifurcations are a challenging lesion subset involving a main vessel (MV) and its side branch (SB). A bifurcation lesion may be looked upon as the proximal MV, the distal main vessel, the SB and the area of the bifurcation. Short- and long-term results depend on optimal handling of all… View more

Imaging & Diagnostics

Prevention & Chronic Conditions
Author(s): Nicolas Foin , Eduardo Alegria-Barrero , Ryo Torii , et al Added: 3 years ago
Drug-eluting stents (DESs) have contributed to a significant lowering of the incidence of restenosis and target vessel revascularisation (TVR) in bifurcations.1–4 A randomised study of bifurcation lesions using sirolimus-eluting stents revealed restenosis rates of only 4 % in the main branch (MB) and a TVR rate as low as 8.2 % at six-month follow-up,2 a marked improvement over that in historical… View more

Prevention & Chronic Conditions
Author(s): Goran Stankovic , Zlatko Mehmedbegovic , Milorad Zivkovic Added: 3 years ago
Approximately 15–20% of percutaneous coronary interventions (PCIs) are performed to treat coronary bifurcations. These procedures are renowned for being technically challenging and historically have been associated with lower procedural success rates and worse clinical outcomes compared with non-bifurcation lesions.1,2 A bifurcation lesion is a lesion occurring at, or adjacent to, a significant… View more

MI/ACS

Intervention
Author(s): Robin P Kraak , Maik J Grundeken , Robbert J de Winter , et al Added: 3 years ago
In the past three decades, significant progress has been made in the treatment of coronary artery disease. From the introduction of balloon angioplasty by Andreas Grüntzig in 19771 to metallic drugeluting stents with thin stent struts coated with cytotoxic or cytostatic drugs,2,3 with biocompatible/biodegradable polymers,4 with or without endothelial progenitor cell-capturing technology.5 However… View more

Imaging & Diagnostics

Intervention
Author(s): Roberto Diletti , Nicolas M Van Mieghem Added: 3 years ago
Since Andreas Gruentzig presented his pioneering work in 1977, 'three revolutions' in percutaneous coronary interventions (PCI) have characterised the field of interventional cardiology. Plain old balloon angioplasty (POBA) was refined by the introduction of bare metal stenting (BMS) (second revolution) to address the issue of acute vessel recoil and unacceptably high rates of restenosis. Drug… View more

Intervention
Author(s): John Rawlins , Jehangir Din , Suneel Talwar , et al Added: 3 years ago
A bifurcation lesion within the coronary arterial circulation is defined as a stenosis occurring at, or adjacent to, a significant division of a major epicardial coronary artery.1 Bifurcation lesions account for 1–20% of all percutaneous coronary interventions (PCIs), and treatment remain technically challenging despite advances in PCI techniques and third-generation drug-eluting stent (DES)… View more

Prevention & Chronic Conditions
Author(s): Yves Louvard , Marie-Claude Morice , Thomas Hovasse , et al Added: 3 years ago
Due to anatomical reasons and the distributive function of the coronary tree, bifurcation sites are prone to the development of atherosclerotic lesions as a result of flow turbulence generating pro-atherogenous low wall shear stress (WSS). Over the past few years, coronary bifurcation lesions have been the subject of intense therapeutic discussions fuelled by new definitions, classifications … View more

Intervention
Author(s): Inga Narbute , Sanda Jegere , Indulis Kumsars , et al Added: 3 years ago
Abstract Together with calcified lesions, saphenous vein grafts, chronic total occlusions and unprotected left main lesions, bifurcation lesions are complex lesions that remain among the outstanding challenges of treatment with percutaneous coronary intervention. Bifurcation lesions are associated with increased rates of procedural complications, restenosis and adverse events than lesions in the… View more

Prevention & Chronic Conditions

Intervention
Author(s): Inga Narbute , Sanda Jegere , Indulis Kumsars , et al Added: 3 years ago
Coronary bifurcation disease is present in up to 15–20 % of lesions undergoing percutaneous coronary intervention (PCI) and remains one of the outstanding challenges of treatment with PCI.1,2 PCI for coronary bifurcations is associated with more procedural complications and higher restenosis and adverse event rates than lesions in the body of the vessel.3–7 The introduction of drug-eluting stents… View more

Intervention