EBC - ON DEMAND
European Bifurcation Club 2005, EBC 2005 – Bordeaux, France
STRATEGY ON BIFURCATION LESION TREATMENT
Lessons from bench testing
Author: John Ormiston, MD, Auckland, New Zealand
SUMMARY
- There is no perfect solution to bifurcation stenting
- Bench testing revealed that dilatation through the side of stent causes distortion best corrected by “kissing” balloon post-dilatation
- If there are gaps after “T” stenting, it is because the stent is too distal
- After “crush” bifurcation stenting, “kissing” improves bench and clinical outcomes
- “Kissing” must be performed with balloons equal or larger diameter than deploying balloons
- Mulitple layers of DES may impede endothialization and predispose to thrombosis
- Bifurcation stenting with conventional post-dilatation pressures only minimally damages polymer
- It is possible to severely damage polymer with extreme pressures and repeated post-dilatation
- Risk of damage to polymer should not be an argument for inadequate post-dilatation
- A permanent polymer covering the entire stent may not be necessary.