EBC 2020 - LIVE!NEWS SESSIONThe most important Bifurcation Publications in 2020 - Maciej LesiakDOWNLOAD PDF
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 Ideal LM Author: Rober Jan Van Geuns, MD, PhD, Radboudumc, The Netherlands CONCLUSIONS After 2 years, in patients undergoing LM-PCI, a Bioabsorbable Polymer Everolimus-Eluting Platinum Chromium stent (Synergy) followed by 4 months DAPT was non-inferior to a Permanent Polymer Everolimus- Eluting Cobalt Chromium stent (Xience) followed by 12 months DAPT with respect to the composite end point of death from any cause or MI or ischemia-driven target vessel revascularization. No difference in ischemic events up to 24 months • No difference in definite/probable stent thrombosis • No stent thrombosis in either group from 4 to 12 months (Synergy off DAPT) Excess BARC 3 or 5 bleeding in short DAPT group but... •4/11 were on OAC/NOAC (2 on triple Rx) and 7/11 were off DAPT • Trial not powered for bleeding events
European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain LM SESSION Differential Prognostic Impact of Treatment Strategies for LM Versus Non LM Bifurcation Lesion. Lessons from the COBIS Registries Author: Young Bin Song, MD, PhD, Samsung Medical Center, Korea Stent Technique (1-Stent vs. 2-Stent) The 1-stent strategy, if possible, should initially be considered the preferred approach for the tr eatment of coronary bifurcation lesions, especially LM bifurcation lesions. Clinical Outcomes Between LM VS Non-LM Patients with LM bifurcation showed significantly higher risks of target lesion failure, cardiac d eath or myocardial infarction, and target lesion revascularization compared to those with non-L M bifurcation. CONCLUSION & SUMMARY Patients treated with PCI for an LM bifurcation lesion had poorer outcomes than those with a non-LM bifurcation lesion in the era of second-generation DES. In the treatment of LM bifurcation, the 2-stent strategy was associated with a higher risk of T LF than the 1-stent strategy, mainly driven by higher risk of TLR; however, incidence of cardiac death or MI was not different between the strategies, unlike previous results from the COBIS II registry. In the treatment of a non-LM bifurcation, there were no significant differences in TLF, cardiac death or MI, and TLR between the 1-stent and 2-stent strategy groups.