Bifurcation
About
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The Treatment of Bifurcation Disease is a challenging area in interventional cardiology. It presents a challenge as interventional cardiology takes on increasingly complex coronary cases.
Load moreStudies report that when compared to non-bifurcation stenting, intervention to bifurcation disease is associated with lower rates of success, higher costs, longer hospitalisation and a higher rate of clinical and angiographic restenosis. Whilst the use of drug-eluting stents (DESs) has improved some outcomes, side branch ostial residual stenosis and long-term restenosis remain a problem.
Bifurcation stenting requires a diverse armamentarium of stenting strategies. Provisional stenting to the main vessel, tackling the side branch only if there is a poor angiographic result remains the prevailing approach. Other more complex two stent approaches include those that stent the main branch first, such as elective T-Stenting, the Culotte and TAP approaches. Other approaches include those that stent the side-branch first such as the various Crush approaches. Innovations such as dedicated bifurcation stents and improved stent and balloon technologies will mean bifurcation approaches will expand and evolve rapidly.
With so many different approaches, it can be seen that the most important question in bifurcation disease PCI is selecting the best possible strategy for an individual bifurcation and optimising the performance of this technique. Educating Interventional Cardiologists will be essential to keep up-to-date on the current data and help physicians choose the most relevant procedure for their patient.
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Editor's choice
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Maciej LesiakInterventional Cardiology Review 2016;11(2):124–7
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Shao-Liang Chen, Imad SheibanICR - Volume 4 Issue 1;2009:4(1):70-72
Videos
Key Bifurcation Guidelines from around the web
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Carlos Collet, Yoshinobu Onuma, Rafael Cavalcante, et alEuroIntervention. 2017 May 15;13(1):115-123.
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Alaide Chieffo, David Hildick-SmithEuroIntervention 2016;12(1):47-52
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David Hildick-Smith, Miles W. Behan, Jens Flensted Lassen, et alCirc Cardiovasc Interv 2016;9
Key Bifurcation Presentations From Around The Web
Webinars
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Dr. Hakim BEN-AMER
Round Table Discussions
Live Streams
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Dr. Nicolas M. Van Mieghem
MedShr Cases
Simple Education Videos
Key Bifurcation Articles from around the web
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Goran Stankovic
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François Derimay, Souteyrand G, Pascal Motreff, et alAbstract presented at EuroPCR 2016
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Shao-Liang Chen, Ya-Ling Han, Liang-Long Chen, et alClin Trials Regulatory Sci Cardiol 2016;22:4-9
Latest articles
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Angela HoyeInterventional Cardiology Review 2017;12(2):110–15.DOI: .15420/icr.2017:11:2
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Maciej LesiakInterventional Cardiology Review 2016;11(2):124–7DOI: .15420/icr.2016:22:2
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Upul Wickramarachchi, Simon EccleshallInterventional Cardiology Review 2016;11 (2):110–5DOI: .15420/icr.2016:17:3
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Sudheer Koganti, Tushar Kotecha, Roby D Rakhit, et alInterventional Cardiology Review, 2016;11(1):11–6DOI: 10.15420/icr.2016:6:1
Bifurcation Randomized Studies
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Manuel Pan, Soledad Ojeda, Elena Villanueva, et al.JACC Cardiovasc Interv. 2016 Sep 26;9(18):1917-24.
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Johan Bennett, Tom Adriaenssens, Walter Desmet, et al.Catheter Cardiovasc Interv. 2016 Nov 15;88(6):843-853.
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K. Gert van Houwelingen, Liefke C. van der Heijden, Ming Kai Lam, et al.Heart Vessels. 2016 Nov;31(11):1731-1739.
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David Hildick-Smith, Miles W. Behan, Jens Flensted Lassen, et al.Circ Cardiovasc Interv. 2016 Sep;9(9).
Bifurcation Registry/Cohort Studies
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Salvatore Geraci, Hiroyoshi Kawamoto, Giuseppe Caramanno, et alJACC Cardiovasc Interv. 2017 Mar 27;10(6):560-568.
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Song PS, Young Bin Song, Lee JM, et alJACC Cardiovasc Interv. 2016 Sep 26;9(18):1879-86.
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Philippe Généreux, Indulis Kumsars, Joel E. Schneider, et alJACC Cardiovasc Interv. 2016 Jul 11;9(13):1338-46.
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Park TK, Young Bin Song, Jeong Hoon Yang, et alEuroIntervention. 2017 May 2.
Bifurcation Other Studies
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Marc-Alexander Ohlow, Ahmed Farah, Stefan Richter, et alCatheter Cardiovasc Interv. 2016 Sep 21.
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Takao Sato, John Jose, Mohamed El-Mawardy, et alInt J Cardiovasc Imaging. 2017 Feb;33(2):169-175.
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Takayuki Yabe, Mikihoto Toda, Rine Nakanishi, et alJ Cardiol. 2017 Jun;69(6):808-814.
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Mineok Chang, Soo-Jin Kang, Sung-Han Yoon, et alCoron Artery Dis. 2016 Dec;27(8):623-628.
Bifurcation Techniques
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Arka Chatterjee, Brigitta C. Brott, Robin Foley, et alCardiovasc Revasc Med. 2016 Oct - Nov;17(7):456-462.
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Stylianos A. Pyxaras, Gábor G Tóth, Giuseppe Di Gioia, et alCatheter Cardiovasc Interv. 2016 Aug 27.
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Antonio Colombo, Richard J. JabbourEur Heart J. 2016 Jun 21;37(24):1929-31.
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Bernardo Cortese, Davide Piraino, Dario Buccheri, et alInt J Cardiol. 2016 Oct 1;220:589-94.
Bifurcation Case Studies
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Elabbassi W, Al Nooryani ACardiovasc Revasc Med. 2017 Jun;18(4):281-286.
Bifurcation Bioresorbable Vascular Scaffold
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Roberto Diletti, Didier Tchetche, Emanuele Barbato, et alCatheter Cardiovasc Interv. 2016 Sep;88(3):397-406.
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Davide Piraino, Dario Buccheri, Giuseppe Andolina, et alInt J Cardiol. 2016 Jul 15;215:80-3.
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Ashok SethCatheter Cardiovasc Interv. 2017 Jan;89(1):56-58.
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Johan Bennett, Maarten Vanhaverbeke, Nina Vanden Driessche, et alCirc Cardiovasc Interv. 2016 Aug;9(8).
Bifurcation General/Reviews
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Antonio Colombo, Francesco GianniniJACC Cardiovasc Interv. 2016 Jul 11;9(13):1347-8.
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Davide Piraino, Dario Buccheri, Gregory Dendramis, et alInt J Cardiol. 2016 Nov 15;223:282-283.
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Leonardo De LucaCirc Cardiovasc Interv. 2016 Sep;9(9).
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Massoud A. LeesarCatheter Cardiovasc Interv. 2016 Nov 15;88(6):870-871.
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