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Simultaneous inflation of two drug-eluting balloons for the treatment of coronary bifurcation restenosis

EBC - ON DEMAND

European Bifurcation Club 2012 – EBC 2012 – Castelldefels, Spain

Restenosis: how to treat? Cases: left main, non left main

Simultaneous inflation of two drug-eluting balloons for the treatment of coronary bifurcation restenosis

Author: Gregory A. Sgueglia, MD, PhD, Ospedale S. Eugenio, Rome, Italy

 

FRAMING THE PROBLEM

percutaneous treatment of coronary bifurcation restenosis might pose real challenges to the interventional cardiologist for two main reasons:

  • most often DES restenosis
  • multiple stent layers, or uncovered struts forming a neocarena or jailing the side branch, thus worsening geometrical constraints

PENDING ISSUES

  1. previous simple technique with “good kissing” or complex technique
    1. all should get smooth
  2. previous simple technique with no kissing
    1. the original distal cell could not be available anymore because of neointimal growth
  3. previous simple technique with “bad kissing”
    1. difficult to anticipate if DEB features could compensate for inaccurate first procedure

CONCLUSION

  • the kissing DEB approach for the treatment of bifurcation restenosis has a sound rational
  • overall, it appears a straightforward procedure for the treatment restenosis following bifurcation treatment according to virtually any kind of technique
  • pending issues prompt further evaluation

 

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