Read more about the article Megatron Synergy – The new addition to the synergy family

Megatron Synergy – The new addition to the synergy family

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain BOSTON SYMPOSIUM Megatron Synergy. The new addition to the synergy family Author: Yiannis Chatzizisis, MD, PhD, University of Nebraska Medical Center, USA ONGOING/ FUTURE WORK Testing the performance of Megatron with 2-stent techniques in a larger cohort of LM bifurcations Head-to-head comparison of Megatron with other second generation DES Testing the performance of new purpose-built stents dedicated to other segments of the coronary tree e.g, distal segments A large, virtual clinical trial to show improved morphologic and biomechanical endpoints (which serve as surrogates of clinical outcomes) with purpose-built stents.

Read more about the article A patient with distal LM disease and large diameter discrepancy between LAD and LM

A patient with distal LM disease and large diameter discrepancy between LAD and LM

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain BOSTON SYMPOSIUM A patient with distal LM disease and large diameter discrepancy between LAD and LM Author: Jens Flensted Lassen, MD, PhD, Odense University Hospital, Denmark PATIENT HISTORY Male, 60 years, Severe COL, Reduced FEV 1, EF 35 %, Diabetes, Hypertension. Family history of ischemic heart disease. Mid LAD stenosis Ostial LAD stenosis, With plaque in LM FFR: 0.67 (distally LAD) and 0.79 (between LM and proximal LAD.) Heart team decision: PCI

Read more about the article LM bifurcation PCI with the novel Megatron Synergy Stent: a case based discussion

LM bifurcation PCI with the novel Megatron Synergy Stent: a case based discussion

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain BOSTON SYMPOSIUM LM bifurcation PCI with the novel Megatron Synergy Stent: a case based discussion - Introduction Author: Thierry Lefevre, MD, PhD, ICPS, France The dream of interventional cardiologist for LM disease A stent with a good radial strength With more than 2 connectors A good visibility A low risk of longitudinal compression An optimal scaffolding and drug delivery An easy side branch access

Read more about the article Risk of stent sizing according to the distal MV in LM bifurcation

Risk of stent sizing according to the distal MV in LM bifurcation

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain BENCH & COMPUTATIONAL BIFURCATION STENT SIMULATIONS Risk of stent sizing according to the distal MV in LM bifurcation Author: Yutaka Hikichi, MD, PhD, Saga University, Japan BACKGROUND AND PURPOSE OF THE EXPERIMENT Size selection: according to the distal MB reference? Hypothesis: Stent size influence the acute outcome Implantation methods CONCLUSION When performing a crossover stent to LMT-LAD, the stent size should be selected according to the vessel diameter on the proximal side of the bifurcation. By selecting a larger stent size, the incomplete stent apposition area can be reduced at the LCx ostium after KBT. By doing so, incomplete stent apposition volume can be reduced at the LM-shaft after KBT , and the stent expansion rate can be greatly increased. The risk of injury on the LAD distal side during stent implantation can be reduced by thorough pre- dilatation and devising the stent placement method.

Existing data on drug coated balloons and coronary bifurcation treatment

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain BIFURCATION AND DRUG ELUTING BALLOONS - VOTING Existing data on drug coated balloons and coronary bifurcation treatment Author: Mario Araya, MD, Clinica Alemana De Santiago/ Thorax National Institute, Chile 4 STRATEGIES TESTED DCB with BMS DCB with DES DCB-only strategy DCB in bifurcaAon restenosis WHERE DO WE STAND Trials of DCB in bifurcaAon treatment use different protocols and devices, in small trials. No POT, low kissing. We need more data. Only paclitaxel-coated balloon have been reported. In general, the use of pDCB appears to be effective and safe in SB. The use of pDCB + BMS is inferior to conventional DES treatment The use of pDCB + DES (Everolimus) show excellent results in small registries . Only-DCB strategy is feasible and safe. In Restenosis of bifurcation, including LM, DCB tx show promising results compare to DES

Read more about the article Provisional stenting strategy in Left main

Provisional stenting strategy in Left main

European Bifurcation Club 2014, EBC 2014 - Bordeaux, France CASES: TIPS & TRICKS AND COMPLICATIONS Provisional stenting strategy in Left main Author: Carlos Garcia Alonso, Institut Cardiovasculaire Paris Sud, France

Read more about the article We need a dedicated stent

We need a dedicated stent

European Bifurcation Club 2005, EBC 2005 - Bordeaux, France DEBATE - WHICH APPROACH FOR LM STENTING WITH DES We need a dedicated stent Author: Philippe Guyon, MD, Centre Cardiologique du Nord, Saint Denis, France

Insights from the Thoraxcenter DES

European Bifurcation Club 2005, EBC 2005 - Bordeaux, France DEBATE - Which approach for LM stenting with DES? Which approach for LM stenting with DES? Insights from the Thoraxcenter DES Author: Angela Hoye, MD, Castle Hill Hospital, UK METHODOLOGY As a policy, all elective patients presenting with significant (>50% by visual estimation) LM disease are evaluated by both interventional cardiologists and cardiac surgeons and the decision to opt for PCI or surgery is reached by consensus The interventional strategy was left to the operator’s discretion All patients were maintained on lifelong aspirin, with clopidogrel for 1 month in those treated with BMS, and 6 months for those treated with DES MACE: death CONCLUSION Compared with historical data of bare metal stents, the adverse event rate is lower following DES implantation for LMS disease The majority of adverse events occur within 1 year The long-term angiographic outcome of the main vessel was not significantly affected whether or not the side branch was stented The long-term angiographic outcome of non-stented side branches was similar to that of stented side branches Both single stent and 2-stent strategies appear to be reasonable options for the therapy of distal LMS disease There is unlikely to be a single strategy that is broadly applicable to all anatomies and lesion subtypes. Further research with randomised studies is needed to evaluate outcomes with respect to the strategy used for differing bifurcation lesions

Read more about the article Unprotected distal Left Main PCI: The Pro

Unprotected distal Left Main PCI: The Pro

European Bifurcation Club 2005, EBC 2005 - Bordeaux, France DEBATE - The case of distal left main lesions: Should we treat it ? Unprotected distal Left Main PCI: The Pro Author: Marc Silvestri, MD, France