European Bifurcation Club 2009 – EBC 2009 – Berlin, Germany
Bifurcation angles: infuence on bifurcation stenting indication?
Bifurcation angle as a factor of events
Author: Vladimír Džavík MD, University of Toronto, Toronto, Ontario, Canada
CRUSH STUDY CONCLUSION
- A high bifurcation angle is associated with a greater risk of long-term major adverse cardiac events in patients undergoing crush stenting procedures of coronary bifurcation lesions.
- This risk is further augmented when the side-branch is not recrossed and post-dilated, most commonly finishing with a kissing balloon inflation, and in the presence of severe baseline renal dysfunction.
- Strategies to optimize the result of the procedure and optimal antiplatelet regimens must always be implemented.
- Further studies are warranted to confirm these findings and to determine if optimal mechanical and pharmacological management can further improve outcome of patients with coronary bifurcation lesions treated by crush stenting techniques.
DOES BIFURCATION ANGLE MATTER?
- BOTH ACCESS AND CARINA ANGLE ARE LIKELY IMPORTANT
- TECHNIQUE DEPENDENT
- WE MUST STANDARDIZE OR ASSESSMENT OF THE BIFURCATION ANGLES
- PROSPECTIVE STUDIES ARE NEEDED