Korean Circulation Journal

  • 제48권6호
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  • Pages.481-491
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  • 2018
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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Understanding the Coronary Bifurcation Stenting

  • Gwon, Hyeon-Cheol (Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2018.03.19
  • 심사 : 2018.04.04
  • 발행 : 2018.06.30
⟨ 이전 논문 다음 논문 ⟩

초록

Coronary bifurcation stenting is still complex and associated with a high risk of stent thrombosis and restenosis even with contemporary techniques. Although provisional approach has been proved to be the standard strategy of treatment, There is still lack of evidences for multiple steps of the procedure. For so many years we have been focused on the optimization of side branch (SB), but the clinical outcome is mostly dependent on the main vessel (MV) stenting. The optimal expansion of MV stent without the compromise of SB is the ultimate goal to achieve in the coronary bifurcation stenting. Understanding the anatomy and physiology of coronary bifurcation lesion should be the most important step to this goal. The relationship of vessel diameter between branches and the anatomical and functional significance of plaque shift and carina shift are two most important concepts to understand. They are the science behind the predictors of SB occlusion, and the rationale of proximal optimization technique and final kissing ballooning. This specific review will be devoted to review those concepts as well as clinical evidences to support them.

키워드

참고문헌

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  2. Coronary Bifurcation Lesion-Management vol.5, pp.2, 2018, https://doi.org/10.1055/s-0040-1713963
  3. 3D reconstruction of coronary artery bifurcations from coronary angiography and optical coherence tomography: feasibility, validation, and reproducibility vol.10, pp.1, 2018, https://doi.org/10.1038/s41598-020-74264-w
  4. Comparison of 2-Stenting Strategies Depending on Sequence or Technique for Bifurcation Lesions in the Second-Generation Drug-Eluting Stent Era ― Analysis From the COBIS (Coronary Bifurcation Stenting vol.85, pp.11, 2018, https://doi.org/10.1253/circj.cj-20-0999
  5. Drug coated balloons for coronary artery bifurcation lesions: A systematic review and focused meta-analysis vol.16, pp.7, 2018, https://doi.org/10.1371/journal.pone.0251986
  6. Ten‐Year Trends in Coronary Bifurcation Percutaneous Coronary Intervention: Prognostic Effects of Patient and Lesion Characteristics, Devices, and Techniques vol.10, pp.18, 2018, https://doi.org/10.1161/jaha.121.021632