Provisional stenting or not provisional stenting: seven critical points for bifurcations treatment with a glimpse on left main bifurcation stenting

Minerva Cardiol Angiol. 2021 Jun;69(3):322-330. doi: 10.23736/S2724-5683.20.05294-9. Epub 2020 Sep 30.

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.

Publication types

  • Review

MeSH terms

  • Angioplasty, Balloon, Coronary*
  • Coronary Artery Disease* / surgery
  • Coronary Stenosis*
  • Humans
  • Stents
  • Treatment Outcome