Finch William, Lee Michael S
Division of Cardiology, UCLA Medical Center, Los Angeles, CA.
Rev Cardiovasc Med. 2017;18(2):59-66. doi: 10.3909/ricm0868.
Percutaneous coronary intervention (PCI) of lesions at coronary bifurcations poses a technical challenge. Short-term complications, including periprocedural myocardial infarction, and long-term complications such as in-stent restenosis and stent thrombosis, are higher in patients with bifurcation lesions. Techniques for PCI of bifurcation lesions include stenting of the main branch alone, and the use of two or more stents to cover the main and side branches. Two- or three-stent techniques include T-stenting, crush, culotte, simultaneous kissing stents, V-stenting, and Y-stenting. The goal of these techniques is to minimize areas of vessel that are not covered by stent. Dedicated bifurcation stents exist, including stents with apertures that allow standard stents to be placed within the aperture. Simultaneous kissing balloon angioplasty in the two branches should be performed to optimize angiographic results. Many studies exist comparing the different techniques; however, no consensus exists on the preferred method.
冠状动脉分叉病变的经皮冠状动脉介入治疗（PCI）是一项技术挑战。分叉病变患者的短期并发症，包括围手术期心肌梗死，以及长期并发症，如支架内再狭窄和支架血栓形成，发生率更高。分叉病变PCI技术包括仅对主支进行支架置入，以及使用两个或更多支架覆盖主支和分支。双支架或三支架技术包括T型支架置入术、挤压术、裤裙式支架置入术、同步挤压支架置入术、V型支架置入术和Y型支架置入术。这些技术的目标是尽量减少未被支架覆盖的血管区域。有专门的分叉支架，包括带有小孔的支架，可将标准支架置于小孔内。应在两个分支中同时进行亲吻球囊血管成形术以优化血管造影结果。有许多研究比较了不同技术；然而，对于首选方法尚无共识。
