Predictors of ostial side branch damage during provisional stenting of coronary bifurcation lesions not involving the side branch origin: an ultrasonographic study

Abstract

The "eyebrow" sign is a powerful predictor of ostial SB damage after stent implantation in the MB in bifurcation coronary lesions without plaque involving the SB.

Intravascular ultrasound‐guided systematic two‐stent techniques for coronary bifurcation lesions and reduced late stent thrombosis

“…Bifurcation coronary artery disease accounts for 20–30% of lesions undergoing percutaneous coronary intervention (PCI). Previous studies focused on stenting bifurcation lesions have reported an increased rate of target lesion/vessel failure when compared to non‐bifurcation lesions.…”

Side branch complication after a single-stent crossover technique

“…Actually, we could easily measure the length and arc degree of fine geometric feature structures around bifurcation lesions including the carina with FD-OCT. Our FD-OCT study with longitudinal image reconstruction showed that the SB branching angle itself was correlated with the SB complication. Earlier studies using angiography showed an inconsistent role of SB angle in the development of SB complication [14,15,18]. These previous results might have been obtained because of the lower reproducibility or inaccurate measurement of the SB angle because of overlapping two-vessel and/or heart motion artifact, which has been overcome by FD-OCT.…”

“…These findings indicate that shift of carina, but not of atheromatous plaque, was the main cause for SB narrowing in the case of a bifurcation lesion without baseline stenosis in SB ostium. Suárez de Lezo et al [15] have previously examined the relation between the morphology of carina and the development of SB complication using IVUS for imaging modality. Supporting our observation, they also observed that bifurcation lesions with plaque within the carina had a lower rate of ostial stenosis after MV stent implantation when compared with bifurcation lesions without plaque at the carina.…”

Kissing Balloon Inflation in Percutaneous Coronary Interventions

“…These patients had a significantly increased rate of late inducible ischemia and minor adverse coronary events (19). Angiographic (20) and intravascular ultrasound (IVUS) (21) predictors of SB damage have been described, with further insights recently provided by 3-dimensional optical coherence tomography (OCT) (22). Main aspects of anatomic complexity of bifurcation lesions include variable distribution of atherosclerosis, variable spatial relation between the branches defined by angles A, B, and C, the tapered nature of the side branch as reflected by a bigger ostial diameter, and the asymmetrical geometric reduction of the vessel diameter at the bifurcation site.…”