Technique Crossover in Stenting Coronary Bifurcation

Abstract

Planning and guiding PCI in a complex intervention is very important and one of the most important decisions is the one on whether to use one or two stent bifurcation techniques. Unfortunately, this can easily turn into complication and the need to alter the procedural strategy. The main points to be considered when deciding on the PCI strategy are related to both procedural safety and long-term outcomes. Provisional stenting has been recommended as the default technique for most coronary bifurcation lesions. In this paper, we describe the case of a patient scheduled for elective procedure of bifurcation lesion of LAD/D1. Our planned strategy was provisional stenting of LAD, using one stent for LAD, DCB for D1. Due to the complication that occurred, i.e., dissection of LAD after LAD stenting, we changed the strategy to two-stents technique strategy, using Culotte technique.

Keywords

• Bifurcation lesions
• Bifurcation techniques
• One-stent technique
• Two-stent technique
• Culotte