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冠脉叉病变介入技巧ClassificationofbifurcationlesionsaccordingtoplaqueburdenMedinaA.etal.RevEspCardiol.2006;59:183-4一个好还是两个好？如果选２个，应该采取何种策略?策略选择的根据简单化vs复杂化循证结果vs个人选择并发症率(especiallyMI/thrombosis)Stentingforbifurcationlesionsin2007ProvisionalStentingStrategy分支血管的保护与放置支架SidebranchclosureafterPCISide-branchmaybecompromisedfollowingmainvesselstentingDifferenttechniquesoftwostentsbyintentiontotreatbifurcationlesionsTheVstentingtechniqueThesimultaneouskissingstentstechniqueTheVstentingandthesimultaneouskissingstentingtechniqueTheVstentingandthesimultaneouskissingstentingtechniqueTheVstentingandthesimultaneouskissingstentingtechniqueTheTstentingtechniqueThemodifiedTstentingtechniqueTheTandmodifiedTstentingtechniqueColomboetalCirculation2004;109:1244-1249RESEARCHbifurcationsubgroupVstentingvsTstentingProvisionalTstenting优点:HigherproceduralsuccessrateLowerexpenseLowercomplicationsLowerre-PCI7monsTLR<15%。Lefevreetal:ProvisionalTstentingisthegoldenstandardtotreatfalsebifurcationlesion(tpye2,3and4a),mostsubjectsonlyneedonestentimplantation。ThecrushtechniqueThecrushtechniqueThereversecrushorinternalcrushtechniqueThereversecrushorinternalcrushtechniqueThereversecrushorinternalcrushtechniqueThestepcrushtechniqueCase:Thestepcrushtechnique33Firstkissing35SecondkissingFinalresultTheinvertedcrushtechniqueTheinvertedcrushtechniqueRestenosisinMV=12.2%RestenosisinSB=2%TheculottesstentingtechniqueTheculottesstentingtechniqueNordicBifurcationStudyII-TheNordicStentTechniqueStudy:CrushvsCulottestentingNordicBifurcationStudyII-TheNordicStentTechniqueStudy:CrushvsCulottestentingTheYstentingtechniqueTheskirttechniqueTheYstentingtechniqueandTheskirttechniqueTheYstentingtechniqueClassificationofbifurcationlesionsaccordingtoplaqueburdenThanksforyourattention!
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