open access
Calcific lesion preparation for coronary bifurcation stenting
Affiliations- Interventional Cath Lab, ASL 2 Abruzzo, Chieti, Italy
- Institute of Cardiology “G. d’Annunzio University”, Chieti, Italy, Italy
- Institute of Cardiology, “G. d’Annunzio University”, Chieti, Italy
open access
Abstract
Bifurcating coronary lesions are a very common challenge in interventional cardiology because of the
technical complexity in their treatment, the risk of side branch occlusion and an overall worse outcome
when compared to non-bifurcating lesions.
The presence of calcifications represents further complexity due to the difficulty in device delivery and
stent expansion as well as enhanced risk of side branch occlusion.
Rotational and orbital atherectomy, scoring and cutting balloons, coronary lithoplasty are available tools
which have been introduced over the last three decades to overcome such issue. Nevertheless, their application in different contexts of bifurcations presents specific caveats and the studies directed at comparing such techniques have never been expressly oriented in the subset of the bifurcating lesion.
In this paper, we review these devices and their usefulness in bifurcations by analyzing consistent data
from clinical trials, and we propose a practical algorithm for the treatment of severely calcified bifurcating
lesions according to their anatomical features.
Abstract
Bifurcating coronary lesions are a very common challenge in interventional cardiology because of the
technical complexity in their treatment, the risk of side branch occlusion and an overall worse outcome
when compared to non-bifurcating lesions.
The presence of calcifications represents further complexity due to the difficulty in device delivery and
stent expansion as well as enhanced risk of side branch occlusion.
Rotational and orbital atherectomy, scoring and cutting balloons, coronary lithoplasty are available tools
which have been introduced over the last three decades to overcome such issue. Nevertheless, their application in different contexts of bifurcations presents specific caveats and the studies directed at comparing such techniques have never been expressly oriented in the subset of the bifurcating lesion.
In this paper, we review these devices and their usefulness in bifurcations by analyzing consistent data
from clinical trials, and we propose a practical algorithm for the treatment of severely calcified bifurcating
lesions according to their anatomical features.
Keywords
bifurcation; calcified lesion; plaque modification; rotational atherectomy; coronary lithoplasty
About this articleTitle
Calcific lesion preparation for coronary bifurcation stenting
Journal
Issue
Pages
429-437
Published online
2019-09-25
Page views
1658
Article views/downloads
2555
DOI
Pubmed
Bibliographic record
Cardiol J 2019;26(5):429-437.
Keywords
bifurcation
calcified lesion
plaque modification
rotational atherectomy
coronary lithoplasty
Authors
Matteo Perfetti
Fabio Fulgenzi
Francesco Radico
Alessandro Toro
Antonio Procopio
Nicola Maddestra
Marco Zimarino
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