The optimal treatment of true bifurcation lesions not affecting the left main coronary artery is widely debated. Results from randomized studies have shown neutral or worse outcomes with the two-stent technique. Regarding these studies, researchers used first-generation stents and the secondary branches were small. The EBC TWO study compared the provisional stenting strategy against the...
Calcified coronary plaque (CCP) is a challenge for interventional cardiology. Stent underexpansion (SU) commonly associated with CCP could predispose to stent thrombosis or restenosis. Currently, SU in severe CCP can be treated by rotational atherectomy, orbital atherectomy, balloon cutting/scoring, non-compliant high-pressure balloons, or intravascular lithotripsy (IVL). The aim of this meta-analysis was to determine the...
The EBC TWO in Non-LM study randomized 200 patients with bifurcation lesions not affecting the left main coronary artery (LCA) to receive provisional stenting vs. culotte (Norobi stent). The secondary branch had to have a diameter ≥2.5 mm and a lesion length >5 mm. The crossover of those who received provisional stenting to the two-stent strategy was 16%....
The EBC MAIN LM study randomized 467 patients with severe left main coronary artery (LCA) lesions to receive provisional stenting or a two-sent strategy (Resolute or Onix stent). The two-stent strategy was decided by the operator (culotte, DK-minicrush, T/TAP). The crossover rate from those randomized to provisional stenting was 22%. After a 3-year follow-up, the composite...
Coronary obstruction is a complication from TAVR that can cause death (up to 50% mortality), even though its incidence is lower than 1%. One of the most frequent strategies used in the prevention of this complication is chimney stenting in patients at high anatomical risk (valve in valve, narrow sinotubular junction, short coronary ostium height)....
Provisional stenting is the most frequent strategy and the most recommended in the treatment of bifurcations, even though in some situations the two-step kiss technique is prioritized, seeing as it offers the benefit of better rheology, less side branch occlusion, less periprocedural injury, better angina control and less restenosis. It included patients with de novo bifurcation...
MD Sandeep Arunothayaraj presented the 5-year followup of EBC Two (which had not previously shown significant differences in clinical outcomes at 12 months) in patients randomized to provisional stenting vs. systematic culotte in bifurcations that were not left main. The study followed up 200 patients with true bifurcations, side branch ≥2.5mm and lesion length ≥5mm,...
Recent studies have shown that drug-eluting stents with biodegradable polymer and ultrathin struts are safe and effective, including low rates of stent thrombosis. This is why researchers conducted the BIODEGRADE (Biomatrix and Orsiro Drug-Eluting Stents in Angiographic Result in Patients With Coronary Artery Disease) study, which showed the non-inferiority at 18 months of ultrathin biodegradable polymer...
Por Dr. Esmeralci Ferreira.
Por Dr. Eduardo Nagib Gaui.