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.

Impact of Bifurcation Angle on Incomplete Stent Apposition

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain CORONARY BIFURCATION IMAGING Impact of Bifurcation Angle on Incomplete Stent Apposition Author: Masahiro Yamawaki, MD, Saiseikai Yokohama City Eastern Hospital, Japan PURPOSE To investigate the impact of the “Link free and distal re-wiring(LFD)” condition and bifurcation angle on 9-month OCT findings after 1-stenting with final kissing inflation(FKI). CONCLUSION High bifurcation (>55°) angle should be care in case of link-free on carina and distal wiring , due to uncorrected stent distortion on the opposite of side branch (SB) and distal main vessel (MV) by final kissing balloon inflation (FKI), but incomplete stent apposition (ISA) in MV decreased after 9 months Impact of bifurcation angle on 9-month OCT data was minor than those of “link and re-wire position” before FKI in this registry. FKI with optimal condition under 3D-OCT guidance reduced uneven neointima proliferation, ISA and uncovered strut after 9 months. Further study is required to demonstrate clinical impact of OCT guided bifurcation treatment.

What are the best imaging criteria for adequate stent expansion and apposition in bifurcation lesion

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain CORONARY BIFURCATION IMAGING What are the best imaging criteria for adequate stent expansion and apposition in bifurcation lesion Author: Nicolas Amabile, MD, PhD, Institut Mutualiste Montsouris , Paris , France CONCLUSION Best imaging criteria for bifurcation PCI quality assessment are not completely established. Although consensus criteria exist for non bifurcated lesions, they might not be applicable “as they are” to bifurcations. Malapposition criteria can be applied for MV and MB. Special alention must be given in the future to redefine our objectives for adequate stent expansion.

First in man: Trirème

European Bifurcation Club 2007, EBC 2007 - Valencia, Spain NEW DEVICES, NEW TECHNIQUES First in man: Trirème Author: Mary E. Russell, MD