A case of huge coronary perforation during insertion of a long stent in severe calcified bifurcation lesion Author: Yoshinobu Murasato, MD, PhD, Kyushu Medical Center, Japan Take home messages: • A long stent insertion in the calcified bifurcation lesion led to stack of the stent and S-figure flection which resulted in huge coronary perforation. • The situation that 1/3 of the stent remained in the guiding catheter might induce strong push-ability to make S-figure flection in the coronary artery. • When we feel hard resistance during insertion of a long stent, we should consider another option as the following earlier. Biplane fluoroscopy for detailed observation of the stent stack Buddy wire to change the wire bias Guide extension catheter to enhance back-up force and prevent the stent flection inside the coronary artery.
European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain TIPS AND TRICKS IN BIFURCATION PCI - THE SYNERGY BETWEEN EBC AND ASIA Use of DES and DCB in LM Bifuration Lesion Author: Zhanying Han, MD, First Affiliated Hospital of Zhengzhou University, China BACKGROUND Although several stenting techniques are available for the treatment of de novo coronary bifurcation lesions. The treatment of coronary artery bifurcation still represents a challenge for interventional cardiologist. over the past years, different studies have proposed and analysed the use of drug-coated balloon (DCB) in the treatment of coronary artery bifurcation lesions as an alternative treatment. CLINICAL CHARACTERISTICS Zhang Q Female 76years Paroxysmal chest tightness for 10 years Agravated for 20 days Risk factor: Diabetes 1 year, Angiitis 30 years TAKE HOME MESSAGES For calcified LM bifurcation lesion, intravascular imaging is strongly recommended to help to determine the PCI strategy. Rotablation is effective to modify the calcified plaque in both MV and SB bifurcation lesion DCB may supply an alternative treatment for bifurcation lesions, thus maybe decrease the stent numbers , thrombosis and restenosis risk of side branch.