Left main coronary artery percutaneous coronary intervention is particularly complex when stenting across the distal bifurcation is required in the presence of a diameter mismatch between the proximal main and distal branches. A suboptimal procedural result increases the risk of thrombosis and restenosis. Considering the paucity of data published on this topic, our objective was to provide technical solutions to deal with this complex anatomy. We described four cases showing the use of devices and techniques which allowed us to overcome a diameter discrepancy between adjacent coronary segments: (1) self-expanding nitinol stent; (2) stent platform with noteworthy expansion capacity; (3) the 'extended skirt' technique; (4) the 'trouser-leg' technique. In conclusion, the use of specific strategies and devices allows a safe and effective approach to be used to perform treatment that respects the coronary anatomy, and to optimize percutaneous coronary intervention results in complex scenarios.

Dall'Ara G, Grotti S, Compagnone M, Spartà D, Guerrieri G, Galvani M, et al. (2022). How to deal with vessel diameter mismatch in left main bifurcation stenting. JOURNAL OF CARDIOVASCULAR MEDICINE, 23(9), 600-607 [10.2459/jcm.0000000000001356].

How to deal with vessel diameter mismatch in left main bifurcation stenting

Dall'Ara G
;
Compagnone M;Galvani M;
2022

Abstract

Left main coronary artery percutaneous coronary intervention is particularly complex when stenting across the distal bifurcation is required in the presence of a diameter mismatch between the proximal main and distal branches. A suboptimal procedural result increases the risk of thrombosis and restenosis. Considering the paucity of data published on this topic, our objective was to provide technical solutions to deal with this complex anatomy. We described four cases showing the use of devices and techniques which allowed us to overcome a diameter discrepancy between adjacent coronary segments: (1) self-expanding nitinol stent; (2) stent platform with noteworthy expansion capacity; (3) the 'extended skirt' technique; (4) the 'trouser-leg' technique. In conclusion, the use of specific strategies and devices allows a safe and effective approach to be used to perform treatment that respects the coronary anatomy, and to optimize percutaneous coronary intervention results in complex scenarios.
2022
Dall'Ara G, Grotti S, Compagnone M, Spartà D, Guerrieri G, Galvani M, et al. (2022). How to deal with vessel diameter mismatch in left main bifurcation stenting. JOURNAL OF CARDIOVASCULAR MEDICINE, 23(9), 600-607 [10.2459/jcm.0000000000001356].
Dall'Ara G; Grotti S; Compagnone M; Spartà D; Guerrieri G; Galvani M; Tarantino FF
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/961963
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