European Bifurcation Club 2019 - EBC 2019 - Barcelona, Spain ABBOTT SYMPOSIUM OCT for LM and Bifurcation PCI - Case 1: Complex Bifurcation Author: Tom Johnson, MD, Bristol Heart Institute,…
European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain CONSENSUS SESSION - VOTING LM Bifurcation Distal PCI - If You Use Crush Technique It Should Be DK Crush Author: Imad Sheiban, MD, PhD, Pederzoli Hospital -Pechiera D/G (Verona), Italy Left main Bifurcation : It is different , not MV- SB but 2 MVs .. Optimal treatment should be provided for both branches TAKE HOME MESSAGES: For complex LM BLs, 2-stent technique especially DK crush is associated with Excellent clinical outcome Serial Randomized Clinical Trials were able to demonstrate that in complex bifurcations , DK Crush is associated with better clinical outcome as compared to other techniques and should be be considered a the gold standard when crush technique is used
European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain CONSENSUS SESSION - VOTING When Treating Distal LM with Provisional Approach We Should Systematically Remove Struts in front of the SB - NO! Author: Imad Sheiban, MD, PhD, Pederzoli Hospital -Pechiera D/G (Verona), Italy Why KBI ? To keep SB open and avoid peri-procedural SB occlusion ( MI ) Optimise stent expansion at the carina Cover SB ostium with the stent Correct stent deformation caused by SB opening Keep access for future interventions Final Remarks In single stenting avoid unnecessary KBI ; kissing balloon inflation or pressure wire interrogation, should be used when an angiographically significant (>70%) side branch lesion remains ader main branch stenting Proximal Optimization Technique (POT) - if no symptoms , no T-ST modifications and TIMI III flow in SB - should not be followed by KBI or any intervention on When required KBI should be performed optimally and followed by final POT to insure optimal expansion and stent apposition
European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain LM SESSION Assessing Optimal Percutaneous Coronary Intervention for Left Main Coronary Artery Stenting Registry Author: Kazushige Kadota, MD, PhD, Kurashiki Central Hospital, Japan SUMMARY 1 The Long-term outcomes ager stent implantation for unprotected LMCA lesions were not determined by the bifurcation lesion types, but were related to the 2- stent strategy. Also, the difference in the rates of TLR and ST between 1-stent and 2-stent strategies were observed within 1 year. SUMMARY 2 Drug-eluting stent implantation ager rotational atherectomy was a safe and feasible strategy for complex bifurcation lesions. In this strategy, the 2-stent approach was associated with markedly worse 5-year clinical outcomes than the 1-stent approach. The events rate within 1 year were significantly higher for all outcomes in the 2-stent strategy group than in the 1-stent strategy group. CONCLUSION The AOI-LMCA registry confirmed that a simple stenting strategy could be recommended for treating leg main bifurcation lesions in real world practice. Meticulous care should be paid within 1 year after using a complex stenting strategy.
European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain LM SESSION Coronary CT Guided Left Main Bifurcation PCI Author: Masaaki Okutsu, MD, New Tokyo Hospital, Chiba, Japan Introduction Current consensus of LMT bifurcation PCI recommends single stent strategy. However, LCX ostium has sometimes severe stenosis or occlusion after crossover stenting unexpectedly. There are some factors that affect to jailed LCX ostium. – MB plaque, SB plaque, low angle, and ...Calcification is one of them. Objective To investigate the relationship between calcium thickness at LMT bifurcation and LCX ostium deterioration after LMT-LAD crossover single stenting. Conclusion Coronary CT might be able to measure calcium thickness. Calcium thickness of ostial LAD might affect LCX ostium stenosis deterioration after crossover stenting from LMT to LAD.