European Bifurcation Club 2007, EBC 2007 – Valencia, Spain

PARALELL WORKSHOP DEBRIEFING

Bifurcation and Stent Thrombosis debriefing

Author: Bernard De Bruyne, MD, PhD, Cardiovascular Centre, Aalst, Belgium

1. What we know
   1. Bifurcation stenting is technically more challenging than an average lesion
   2. The bifurcation is a paradigm of Virchow’s triad (abnormal vessel wall, rheology and coagulation) which create a thrombogenic evironment
   3. There is an inverse relationship between procedure complexity and clinical outcome
2. What we thought we knew
   1. Bifurcation is a potent, independent risk factor for stent thrombosis
   2. Late stent thrombosis is rare when up-to-date principles of ‘good stenting’ are applied
3. What we don’t know
   1. Is final kissing always mandatory?
4. What we would like to know 
   1. Is final kissing always mandatory?
   2. What is the rate of distal LM LST (Syntax LM patients)
   3. Is clinical outcome influenced by dedicated stent?
   4. Is platelet aggregation testing clinically useful or will it be overuled by newer P2Y12 receptor blockers (Prasugrel, Cangrelor)

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