Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, İstanbul, Türkiye.
Anatol J Cardiol. 2023 Feb;27(2):113-116. doi: 10.14744/AnatolJCardiol.2022.2689.
Percutaneous coronary intervention (PCI) of coronary bifurcation lesion (CBL) is challenging due to its complex anatomy resulting in difficulty in deciding on treatment procedure. Although there are advanced techniques and well-experienced operators, the optimal stenting strategy is still debated. The contemporary PCI techniques of CBL aim to achieve minimal stent protrusion to the main vessel and to minimize stent layers at the neocarina as well as the side branch (SB) ostium and proximal main vessel (PMV). In addition, it is necessary to avoid incomplete stent coverage at the SB ostium and stent malapposition. Traditional 2-stent strategies have been improved using minimal stent protrusion to the main vessel (MV) and double kissing (DK) balloon dilatation to reach optimal results. Although the DK crush has been the prominent treatment modality,1 there are studies showing that the DK culotte stenting may have better results especially in terms of stent malapposition and metal layers at the neocarina.2 In our case report, we demonstrate a novel minimal protruded DK nanoculotte stenting technique for the treatment of true CBL.
经皮冠状动脉介入治疗（PCI）分叉病变（CBL）具有挑战性，因为其复杂的解剖结构导致难以决定治疗程序。尽管有先进的技术和经验丰富的操作人员，但最佳的支架置入策略仍存在争议。当代 CBL 的 PCI 技术旨在实现最小的支架向主血管突出，并最大限度地减少新嵴以及边支（SB）开口和近端主血管（PMV）的支架层数。此外，还需要避免 SB 开口处支架不完全覆盖和支架贴壁不良。已经使用最小的支架向主血管（MV）突出和双对吻（DK）球囊扩张来改进传统的 2 支架策略，以达到最佳效果。虽然 DK 挤压一直是突出的治疗方式，1 但有研究表明 DK 外套管支架置入术可能具有更好的效果，尤其是在支架贴壁不良和新嵴的金属层方面。2 在我们的病例报告中，我们展示了一种用于治疗真性 CBL 的新型最小突出 DK 纳米外套管支架置入技术。
