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Balloons and stent sizing for bifurcation PCI Role of Intra-coronary Imaging

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European Bifurcation Club 2019, EBC 2019 – Barcelona, Spain

CORONARY BIFURCATION IMAGING

Balloons and stent sizing for bifurcation PCI Role of Intra-coronary Imaging

Author: Yoshinobu Murasato, MD, PhD, Kyushu Medical Center, Japan

 

TAKE HOME MESSAGES

  • Device sizing (general):
    • EEL-based reference diameter measurement is firstly recommended.
    • In case of invisible EEL, lumen-based measurement is also available.
    • For the optimal stent landing zone, it is important to avoid dissection, > 50% plaque burden, and lipid pool.
  • Device sizing: bifurcation lesion
    • POT and KBI balloon should be selected according to vascular branching law.
    • In the bifurcation lesion, Finet’s law is applicable for imaging-guide reference diameter measurement, not for angio-based one.
    • Stent should be selected considering maximal expansion capacity.
    • Minimum expansion index considering vascular branching and tapering is more physiological to select post-dilation site and appropriate balloon.

 

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