A Novel guide extension assisted stenting technique for coronary bifurcation lesions

作     者：Shams Y-Hassan Rodney de Palma 

作者机构：Coronary Artery Disease AreaHeart and Vascular ThemeKarolinska Institutet and Karolinska University HospitalStockholm S-14186Sweden Buckinghamshire Healthcare NHS TrustBuckinghamshire HP112TTUnited Kingdom 

出 版 物：《World Journal of Cardiology》 (世界心脏病学杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第6期

页      面：155-162页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Coronary bifurcation lesion GuideLiner stenting Percutaneous coronary intervention One-or two-stenting technique Novel descriptive,intelligible and ordered 

摘      要：A challenging technical scenario frequently encountered in a percutaneous coronary intervention of a coronary bifurcation lesion(CBL)is stent implantation of only the stenosed segment without compromising the other two normal segments in non-true bifurcation *** is precise stent implantation covering the side branch ostium without leaving excessive stent metal at the other two segments of a bifurcation lesion in complex true bifurcation *** aim of this study was to describe a novel stenting technique for both non-true and true CBLs by using a guide extension catheter(GuideLiner).With the assistance of a guide extension catheter mounted on both the main and the side-branch guidewires and with its intubation down to the bifurcation carina,a stent can be implanted in the side branch segment or distal main segment of the bifurcation lesion appropriately without compromising the other two segments of the coronary *** implantation is described in three bifurcation lesions in three cases and shown in detail with illustrative *** technique facilitates side-branch only stenting in side-branch mono-ostial(medina 0,0,1)CBL or only the distal main segment in distal mono-ostial(medina 0,1,0)CBL without compromising the other two remaining segments when using the onestent technique in non-true CBLs without leaving unnecessary excessive stent metal at the bifurcation site and when using a two-stent technique in complex true bifurcation lesions(tri-ostial or medina 1,1,1).Consequently,through optimizing stent deployment,the technique may have the potential to reduce the risk of subacute stent thrombosis and future in-stent *** most appropriate lesions suitable for the technique,and some other practical tips are also described.