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Calcific lesion preparation for coronary bifurcation stenting

Bifurcating coronary lesions are a very common challenge in interventional cardiology because of the technical complexity in their treatment, the risk of side branch occlusion and an overall worse outcome when compared to non-bifurcating lesions. The presence of calcifications represents further com...

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Autores principales: Perfetti, Matteo, Fulgenzi, Fabio, Radico, Francesco, Toro, Alessandro, Procopio, Antonio, Maddestra, Nicola, Zimarino, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Via Medica 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8084380/
https://www.ncbi.nlm.nih.gov/pubmed/31565792
http://dx.doi.org/10.5603/CJ.a2019.0094
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author Perfetti, Matteo
Fulgenzi, Fabio
Radico, Francesco
Toro, Alessandro
Procopio, Antonio
Maddestra, Nicola
Zimarino, Marco
author_facet Perfetti, Matteo
Fulgenzi, Fabio
Radico, Francesco
Toro, Alessandro
Procopio, Antonio
Maddestra, Nicola
Zimarino, Marco
author_sort Perfetti, Matteo
collection PubMed
description Bifurcating coronary lesions are a very common challenge in interventional cardiology because of the technical complexity in their treatment, the risk of side branch occlusion and an overall worse outcome when compared to non-bifurcating lesions. The presence of calcifications represents further complexity due to the difficulty in device delivery and stent expansion as well as enhanced risk of side branch occlusion. Rotational and orbital atherectomy, scoring and cutting balloons, coronary lithoplasty are available tools which have been introduced over the last three decades to overcome such issue. Nevertheless, their application in different contexts of bifurcations presents specific caveats and the studies directed at comparing such techniques have never been expressly oriented in the subset of the bifurcating lesion. In this paper, we review these devices and their usefulness in bifurcations by analyzing consistent data from clinical trials, and we propose a practical algorithm for the treatment of severely calcified bifurcating lesions according to their anatomical features.
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spelling pubmed-80843802021-05-10 Calcific lesion preparation for coronary bifurcation stenting Perfetti, Matteo Fulgenzi, Fabio Radico, Francesco Toro, Alessandro Procopio, Antonio Maddestra, Nicola Zimarino, Marco Cardiol J Interventional Cardiology Bifurcating coronary lesions are a very common challenge in interventional cardiology because of the technical complexity in their treatment, the risk of side branch occlusion and an overall worse outcome when compared to non-bifurcating lesions. The presence of calcifications represents further complexity due to the difficulty in device delivery and stent expansion as well as enhanced risk of side branch occlusion. Rotational and orbital atherectomy, scoring and cutting balloons, coronary lithoplasty are available tools which have been introduced over the last three decades to overcome such issue. Nevertheless, their application in different contexts of bifurcations presents specific caveats and the studies directed at comparing such techniques have never been expressly oriented in the subset of the bifurcating lesion. In this paper, we review these devices and their usefulness in bifurcations by analyzing consistent data from clinical trials, and we propose a practical algorithm for the treatment of severely calcified bifurcating lesions according to their anatomical features. Via Medica 2019-11-06 /pmc/articles/PMC8084380/ /pubmed/31565792 http://dx.doi.org/10.5603/CJ.a2019.0094 Text en Copyright © 2019 Via Medica https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
spellingShingle Interventional Cardiology
Perfetti, Matteo
Fulgenzi, Fabio
Radico, Francesco
Toro, Alessandro
Procopio, Antonio
Maddestra, Nicola
Zimarino, Marco
Calcific lesion preparation for coronary bifurcation stenting
title Calcific lesion preparation for coronary bifurcation stenting
title_full Calcific lesion preparation for coronary bifurcation stenting
title_fullStr Calcific lesion preparation for coronary bifurcation stenting
title_full_unstemmed Calcific lesion preparation for coronary bifurcation stenting
title_short Calcific lesion preparation for coronary bifurcation stenting
title_sort calcific lesion preparation for coronary bifurcation stenting
topic Interventional Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8084380/
https://www.ncbi.nlm.nih.gov/pubmed/31565792
http://dx.doi.org/10.5603/CJ.a2019.0094
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