Imaging in Bifurcation – Parallel Session Summary

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain IMAGING IN BIFURCATION - PARALLEL SESSION SUMMARY Author: Zlatko Mehmedbegovic, MD, Clinical Center of Serbia, Belgrade, Serbia Balloons & stent sizing…

When Treating Distal LM with Provisional Approach We Should Systematically Remove Struts in Front of the SB. No

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

The CABRIOLET Registry

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain NEWS 3 The CABRIOLET Registry Preliminary Results - Coronary Artery Bifurcation Revascularization without kIssing ballOon infLation by rE-poT. Author: Francois Derimay, MD, PhD, Hôpital Cardiologique de Lyon, France THE CABRIOLET REGISTRY Multi center registry Aim: 500 complete re-POT All provisional stenting strategies Retrospective and prospective inclusions (end of inclusion in May 2019) Clinical FU 1 year minimum, up to 5 years CONCLUSION Preliminary datas of CABRIOLET registry but: Re-POT technique is safe and easy, available in a large range of bifurcation Pure sequential provisional technique respecting perfectly the physiological fractal geometry Perfect initial angiographic results Excellent clinical results at 1 year (2% of TVF) Final analysis in Mid 2020 (see you in the next EBC)

Bench evaluation of the Fantom scaffold (REVA) in bifurcations

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain NEWS 1 Usability of Fantom Bioresorbable Scaffold in Non Complex Bifurcations: Technical Analysis in Bench Models Author: Gabor G. Toth, MD, PhD, University Heart Centre Graz, Austria AIM To evaluate, whether POT-SB-POT technique can be considered as a reasonable bail-out option for Fantom® bioresorbable scaffold, to tackle a simple bifurcation lesion CONCLUSION Fantom® polycarbonate copolymer coronary scaffold is considered to have improved structural characteristics Still, marked structural destruction of the scaffold has been observed in bench models when doing POT-SB-POT approach Considering that POT-SB-POT might be ‘the most gentle’ bifurcation technique from device point of view Therefore the use of Fantom® in any bifurcation anatomy should be strongly discouraged.

Early Morning Bench News: DK Double Crush

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain NEWS 1 Early Morning Bench News: DK Double Crush Author: Niels Ramsing Holm, MD, Aarhus University Hospital, Denmark SUMMARY Double crush in DK crush may lower risk of sub-optimal SB rewiring Use POT balloon sized to proximal reference Intravascular imaging is still required to firmly rule out suboptimal rewiring Clincal data: OCTOBER trial

Clinical Case

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain CASE SESSION - TIPS & TRICKS Clinical Case Author: Julien Adjedj, MD, Institut Arnault Tzanck, France 68 YEAR OLD MALE PATIENT HIV Previous inferior MI in 2006 Left main equivalent PCI in 2006 Cypher 3.5 x 18 mm Dyspnea NYHA II LVEF 40% inferior akinesia