复杂冠脉分叉病变的PCI治疗策略PPT.ppt

PCI Strategies for Complex Coronary Bifurcation lesions; One or two stents?;Nordic Bifurcation Study (n=413);Primary Endpoint of MACE at 6 months (%) p=NS;Procedure related MI was defined as a five-fold elevation of biochemical markers Procedure related MI occurred more than three times as often in the MV+SB group (13% vs 4%; p=0.008);Provision-T stent technique; The SB has a narrowing at its ostium;FKB is Very Important for Provisional T Stent;Two Stents Techniques;;;Clinical Outcomes;Culotte vs T stent in DES era ;;Clinical Outcome;Clinical Outcome;;;Clinical Outcomes; Colombo et al. PCR 2004;Step 1: Wire both branches and predilate both;Wire both branches and predilate;Wire side branch and dilate;Deploy stent in the side branch and remove wire and balloon;Balloon Crush;DK Crush ( Sleeve Technique);mini-crush;TAP technique;Wire side branch and dilate;SB stent positioning;The balloon of the SB stent is slightly retrieved and aligned to the MV balloon ;In vitro TAP stenting;0.070” 0.071’’; 球囊种类（≤3.5mm);球囊外径：2.9F+2.6F=5.5F 6F导管内径：0.070 inch﹤5.4F;;Case of TAP stenting;Coronary Angiography;6F EBU 3.5;Deployment MV stent with jailed guidewire into the SB;SB stent positioning;SB is deployed with the uninflated balloon into MV;Final kissing balloon;Final Result;;Angiographic characteristics;Approach;Clinical outcome (9 month);;Stent implantation in the side branch?;;116 pts with LMCA bifurcation lesions;;;;Compared to the complex stenting approach, the simple approach (stenting cross-over) was technically easier and appeared to be more effective in improving long-term outcomes for lesions with normal or diminutive LCX;Thank you for your attention