Skip to main content
SpringerLink
Log in

Interventional Treatments of Coronary Artery Bifurcations

  • Reference work entry
  • First Online:
PanVascular Medicine

  • 160 Accesses

Abstract

Bifurcation percutaneous coronary intervention (PCI) has shown higher incidence of procedural complications and worse clinical outcomes compared with non-bifurcation PCI. Even though several technical approaches have been advocated for bifurcation PCI, the risk of side branch (SB) compromise is still substantial including flow impairment and/or acute vessel occlusion associated with periprocedural myocardial infarction, dissection, significant residual stenosis associated with cardiac symptoms, and relatively high incidence of restenosis associated with increased rates of target lesion revascularization during the follow-up period. Overall, no clear benefit has been shown in favor of elective complex PCI strategies versus a simple approach; still, because bifurcation lesions present with great variety in terms of location, morphology, and overall complexity, an individual selection of technical approach may be preferable for PCI decision-making.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 649.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 549.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

Bifurcation:

A coronary segment involving three distinct anatomical regions including the proximal segment (main vessel, MV) and the distal segments: main branch (MB) and side branch (SB).

Bifurcation lesion:

Stenosis of at least 50 % located within 3 mm of the bifurcation carina.

Carina:

Center or core of a bifurcation.

Carina angle:

Distal angle as measured between the 2 distal branches.

Incomplete stent apposition:

Evidence of stent struts not fully apposed to the vessel wall at a particular segment or cross section.

POT:

Proximal optimization technique, consisting of single balloon postdilatation at the level of the bifurcation carina with a balloon diameter matching the proximal (MV) reference vessel diameter.

Side branch compromise:

Flow impairment, acute vessel occlusion, dissection, or significant residual stenosis.

Stent underexpansion:

A stented segment with expansion less than the reference segment within stented length or outside the stent

Takeoff angle:

Proximal angle as measured between the MV and the SB.

True bifurcation lesion:

When both MV-MB and SB are significantly involved (>50 % stenosis in both branches).

References

  • Abizaid A, De Ribamar Costa J Jr, Alfaro VJ, Feres F, Staico R, Mattos LA, Maldonado G, Sousa JE (2007) Bifurcated stents: giving to Caesar what is Caesar’s. EuroIntervention 2:518–525

    PubMed  Google Scholar 

  • Behan MW, Holm NR, Curzen NP, Erglis A, Stables RH, de Belder AJ, Niemela M, Cooter N, Chew DP, Steigen TK, Oldroyd KG, Jensen JS, Lassen JF, Thuesen L, Hildick-Smith D (2011) Simple or complex stenting for bifurcation coronary lesions: a patient-level pooled-analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study. Circ Cardiovasc Interv 4:57–64

    Article  PubMed  Google Scholar 

  • Bezerra HG, Costa MA, Guagliumi G, Rollins AM, Simon DI (2009) Intracoronary optical coherence tomography: a comprehensive review clinical and research applications. J Am Coll Cardiol Intv 2:1035–1046

    Article  Google Scholar 

  • Brar SS, Gray WA, Dangas G, Leon MB, Aharonian VJ, Brar SK, Moses JW (2009) Bifurcation stenting with drug-eluting stents: a systematic review and meta-analysis of randomised trials. EuroIntervention 5:475–484

    Article  PubMed  Google Scholar 

  • Brunel P, Lefevre T, Darremont O, Louvard Y (2006) Provisional T-stenting and kissing balloon in the treatment of coronary bifurcation lesions: results of the French multicenter “TULIPE” study. Catheter Cardiovasc Interv 68:67–73

    Article  PubMed  Google Scholar 

  • Burzotta F, De Vita M, Sgueglia G, Todaro D (2010) How to solve difficult side branch access? EuroIntervention 6:J72–J80

    Article  PubMed  Google Scholar 

  • Burzotta F, Talarico GP, Trani C, De Maria GL, Pirozzolo G, Niccoli G, Leone AM, Saffioti S, Porto I, Crea F (2014) Frequency-domain optical coherence tomography findings in patients with bifurcated lesions undergoing provisional stenting. Eur Heart J Cardiovasc Imaging 15:547–555

    Article  PubMed  Google Scholar 

  • Chaudhry EC, Dauerman KP, Sarnoski CL, Thomas CS, Dauerman HL (2007) Percutaneous coronary intervention for major bifurcation lesions using the simple approach: risk of myocardial infarction. J Thromb Thrombolysis 24:7–13

    Article  PubMed  Google Scholar 

  • Colombo A, Moses JW, Morice MC, Ludwig J, Holmes DR Jr, Spanos V, Louvard Y, Desmedt B, Di Mario C, Leon MB (2004) Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions. Circulation 109:1244–1249

    Article  PubMed  Google Scholar 

  • Colombo A, Bramucci E, Sacca S, Violini R, Lettieri C, Zanini R, Sheiban I, Paloscia L, Grube E, Schofer J, Bolognese L, Orlandi M, Niccoli G, Latib A, Airoldi F (2009) Randomized study of the crush technique versus provisional side-branch stenting in true coronary bifurcations: the CACTUS (Coronary Bifurcations: Application of the Crushing Technique Using Sirolimus-Eluting Stents) study. Circulation 119:71–78

    Article  PubMed  Google Scholar 

  • Costa RA, Moussa ID (2006) Percutaneous treatment of coronary bifurcation lesions in the era of drug-eluting stents. Minerva Cardioangiol 54:577–589

    CAS  PubMed  Google Scholar 

  • Costa RA, Mintz GS, Carlier SG, Lansky AJ, Moussa I, Fujii K, Takebayashi H, Yasuda T, Costa JR Jr, Tsuchiya Y, Jensen LO, Cristea E, Mehran R, Dangas GD, Iyer S, Collins M, Kreps EM, Colombo A, Stone GW, Leon MB, Moses JW (2005) Bifurcation coronary lesions treated with the “crush” technique: an intravascular ultrasound analysis. J Am Coll Cardiol 46:599–605

    Article  PubMed  Google Scholar 

  • Costa RA, Furuichi S, Lansky AJ, Mintz GS, Montorfano M, Carlino M, Michev I, Airoldi F, Latib A, Sangiorgi G, Feres F, Staico R, Mattos LA, Costa JR Jr, Colombo A (2008) Midterm clinical outcomes from the intravascular ultrasound investigation of the parent vessel and the side branch in coronary bifurcation lesions treated with different stenting techniques. J Am Coll Cardiol 51:B51

    Google Scholar 

  • Costa RA, Costa MA, Moussa ID (2011) Bifurcation lesion morphology and intravascular ultrasound assessment. Int J Cardiovasc Imaging 27:189–196

    Article  PubMed  Google Scholar 

  • Costa RA, Feres F, Staico R, Costa J de R Jr, Siqueira D, Abizaid A, Tanajura LF, Sousa A, Sousa JE, Colombo A (2012) Intravascular ultrasound findings in complex coronary bifurcation lesions treated with single stenting versus double stenting strategies. J Am Coll Cardiol 60:B87

    Google Scholar 

  • Costa RA, Feres F, Staico R, Abizaid A, Costa JR Jr, Siqueira D, Tanajura LF, Damiani LP, Sousa A, Sousa JE, Colombo A (2013) Vessel remodeling and plaque distribution in side branch of complex coronary bifurcation lesions: a grayscale intravascular ultrasound study. Int J Cardiovasc Imaging 29:1657–1666

    Article  PubMed  Google Scholar 

  • Dahm JB, Dorr M, Scholz E, Ruppert J, Hummel A, Staudt A, Felix SB (2008) Cutting-balloon angioplasty effectively facilitates the interventional procedure and leads to a low rate of recurrent stenosis in ostial bifurcation coronary lesions: a subgroup analysis of the nicecut multicenter registry. Int J Cardiol 124:345–350

    Article  PubMed  Google Scholar 

  • Ferenc M, Gick M, Kienzle RP, Bestehorn HP, Werner KD, Comberg T, Kuebler P, Buttner HJ, Neumann FJ (2008) Randomized trial on routine vs. provisional T-stenting in the treatment of de novo coronary bifurcation lesions. Eur Heart J 29:2859–2867

    Article  PubMed  PubMed Central  Google Scholar 

  • Finet G, Gilard M, Perrenot B, Rioufol G, Motreff P, Gavit L, Prost R (2007) Fractal geometry of arterial coronary bifurcations: a quantitative coronary angiography and intravascular ultrasound analysis. EuroIntervention 3:490–498

    Article  Google Scholar 

  • Finet G, Gilard M, Perrenot B, Rioufol G, Motreff P, Gavit L, Prost R (2008) Fractal geometry of arterial coronary bifurcations: a quantitative coronary angiography and intravascular ultrasound analysis. EuroIntervention 3(4):490–498

    Google Scholar 

  • Fujii K, Kobayashi Y, Mintz GS, Hirose M, Moussa I, Mehran R, Dangas G, Lansky AJ, Kreps E, Collins M, Colombo A, Stone GW, Leon MB, Moses JW (2003) Dominant contribution of negative remodeling to development of significant coronary bifurcation narrowing. Am J Cardiol 92:59–61

    Article  PubMed  Google Scholar 

  • Furukawa E, Hibi K, Kosuge M, Nakatogawa T, Toda N, Takamura T, Tsukahara K, Okuda J, Ootsuka F, Tahara Y, Sugano T, Endo T, Kimura K, Umemura S (2005) Intravascular ultrasound predictors of side branch occlusion in bifurcation lesions after percutaneous coronary intervention. Circ J 69:325–330

    Article  PubMed  Google Scholar 

  • Ge L, Airoldi F, Iakovou I, Cosgrave J, Michev I, Sangiorgi GM, Montorfano M, Chieffo A, Carlino M, Corvaja N, Colombo A (2005) Clinical and angiographic outcome after implantation of drug-eluting stents in bifurcation lesions with the crush stent technique: importance of final kissing balloon post-dilation. J Am Coll Cardiol 46:613–620

    Article  CAS  PubMed  Google Scholar 

  • Gil RJ, Vassilev D, Michalek A, Kern A, Formuszewicz R, Dobrzycki S, Wojcik J, Lesiak M, Kardaszewicz P, Lekston A (2012) Dedicated paclitaxel-eluting bifurcation stent bioss(r) (bifurcation optimisation stent system): 12-month results from a prospective registry of consecutive all-comers population. EuroIntervention 8:316–324

    Article  PubMed  Google Scholar 

  • Gil RJ, Bil J, Michalek A, Vassiliev D, Costa RA (2013) Comparative analysis of lumen enlargement mechanisms achieved with the bifurcation dedicated bioss) stent versus classical coronary stent implantations by means of provisional side branch stenting strategy: an intravascular ultrasound study. Int J Cardiovasc Imaging 29:1667–1676

    Article  PubMed  PubMed Central  Google Scholar 

  • Grube E, Buellesfeld L, Neumann FJ, Verheye S, Abizaid A, McClean D, Mueller R, Lansky A, Mehran R, Costa R, Gerckens U, Trauthen B, Fitzgerald PJ (2007) Six-month clinical and angiographic results of a dedicated drug-eluting stent for the treatment of coronary bifurcation narrowings. Am J Cardiol 99:1691–1697

    Article  CAS  PubMed  Google Scholar 

  • Hahn JY, Song YB, Lee SY, Choi JH, Choi SH, Kim DK, Lee SH, Gwon HC (2009) Serial intravascular ultrasound analysis of the main and side branches in bifurcation lesions treated with the T-stenting technique. J Am Coll Cardiol 54:110–117

    Article  PubMed  Google Scholar 

  • Hildick-Smith D, de Belder AJ, Cooter N, Curzen NP, Clayton TC, Oldroyd KG, Bennett L, Holmberg S, Cotton JM, Glennon PE, Thomas MR, Maccarthy PA, Baumbach A, Mulvihill NT, Henderson RA, Redwood SR, Starkey IR, Stables RH (2010a) Randomized trial of simple versus complex drug-eluting stenting for bifurcation lesions. The British Bifurcation Coronary study: old, new, and evolving strategies. Circulation 121:1235–1243

    Article  CAS  PubMed  Google Scholar 

  • Hildick-Smith D, Lassen JF, Albiero R, Lefevre T, Darremont O, Pan M, Ferenc M, Stankovic G, Louvard Y (2010b) Consensus from the 5th European Bifurcation Club meeting. EuroIntervention 6:34–38

    Article  PubMed  Google Scholar 

  • Iakovou I, Schmidt T, Bonizzoni E, Ge L, Sangiorgi GM, Stankovic G, Airoldi F, Chieffo A, Montorfano M, Carlino M, Michev I, Corvaja N, Briguori C, Gerckens U, Grube E, Colombo A (2005) Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA 293:2126–2130

    Article  CAS  PubMed  Google Scholar 

  • Kang SJ, Mintz GS, Kim WJ, Lee JY, Park DW, Lee SW, Kim YH, Lee CW, Park SW, Park SJ (2011) Preintervention angiographic and intravascular ultrasound predictors for side branch compromise after a single-stent crossover technique. Am J Cardiol 107(12):1787–1793

    Google Scholar 

  • Kaplan AV, Ramcharitar S, Louvard Y, Muller R, Davis HR, Morice MC, Serruys PW, Grube E (2007) Tryton I, first-in-man (FIM) study: acute and 30 day outcome. A preliminary report. EuroIntervention 3:54–59

    PubMed  Google Scholar 

  • Karanasos A, Tu S, van Ditzhuijzen NS, Ligthart JM, Witberg K, Van Mieghem N, van Geuns RJ, de Jaegere P, Zijlstra F, Reiber JH, Regar E (2014) A novel method to assess coronary artery bifurcations by oct: cut-plane analysis for side-branch ostial assessment from a main-vessel pullback. Eur Heart J Cardiovasc Imaging

    Google Scholar 

  • Koo BK, Park KW, Kang HJ, Cho YS, Chung WY, Youn TJ, Chae IH, Choi DJ, Tahk SJ, Oh BH, Park YB, Kim HS (2008) Physiological evaluation of the provisional side-branch intervention strategy for bifurcation lesions using fractional flow reserve. Eur Heart J 29:726–732

    Article  PubMed  Google Scholar 

  • Koo BK, Waseda K, Kang HJ, Kim HS, Nam CW, Hur SH, Kim JS, Choi D, Jang Y, Hahn JY, Gwon HC, Yoon MH, Tahk SJ, Chung WY, Cho YS, Choi DJ, Hasegawa T, Kataoka T, Oh SJ, Honda Y, Fitzgerald PJ, Fearon WF (2010) Anatomic and functional evaluation of bifurcation lesions undergoing percutaneous coronary intervention. Circ Cardiovasc Interv 3:113–119

    Article  PubMed  Google Scholar 

  • Kralev S, Poerner TC, Basorth D, Lang S, Wolpert C, Haghi D, Borggrefe M, Haase KK, Suselbeck T (2006) Side branch occlusion after coronary stent implantation in patients presenting with ST-elevation myocardial infarction: clinical impact and angiographic predictors. Am Heart J 151:153–157

    Article  PubMed  Google Scholar 

  • Lansky A, Tuinenburg J, Costa M, Maeng M, Koning G, Popma J, Cristea E, Gavit L, Costa R, Rares A, Van Es GA, Lefevre T, Reiber H, Louvard Y, Morice MC (2009) Quantitative angiographic methods for bifurcation lesions: a consensus statement from the European Bifurcation Group. Catheter Cardiovasc Interv 73:258–266

    Article  PubMed  Google Scholar 

  • Latib A, Colombo A (2008) Bifurcation disease: what do we know, what should we do? JACC Cardiovasc Interv 1:218–226

    Article  PubMed  Google Scholar 

  • Latib A, Cosgrave J, Godino C, Qasim A, Corbett SJ, Tavano D, Morici N, Cristell N, Chieffo A, Carlino M, Montorfano M, Airoldi F, Colombo A (2008) Sirolimus-eluting and paclitaxel-eluting stents for the treatment of coronary bifurcations. Am Heart J 156:745–750

    Article  CAS  PubMed  Google Scholar 

  • Lefevre T, Louvard Y, Morice MC, Dumas P, Loubeyre C, Benslimane A, Premchand RK, Guillard N, Piechaud JF (2000) Stenting of bifurcation lesions: classification, treatments, and results. Catheter Cardiovasc Interv 49:274–283

    Article  CAS  PubMed  Google Scholar 

  • Lefèvre T, Darremont O, Albiero R (2010) Provisional side branch stenting for the treatment of bifurcation lesions. EuroIntervention 6:J65–J71

    Article  PubMed  Google Scholar 

  • Leon MB (2008) The capella sideguard stent: design features and results from the sideguard i and ii first-in-man trials. Transcatheter Cardiovasc Ther

    Google Scholar 

  • Lewis BE, Leya FS, Johnson SA, Grassman ED, Hwang M, Loeb HS, Scanlon PJ, Euler D, Keeler G, McKiernan TL (1995) Assessment of outcome of bifurcation lesions and non-bifurcation lesions treated in the CAVEAT trial. CAVEAT investigator group. J Invasive Cardiol 7:251–258

    CAS  PubMed  Google Scholar 

  • Lopez Minguez JR, Nogales Asensio JM, Doncel Vecino LJ, Sandoval J, Romany S, Martinez Romero P, Fernandez Diaz JA, Fernandez Portales J, Gonzalez Fernandez R, Martinez Caceres G, Merchan Herrera A, Alfonso MF (2014) A prospective randomised study of the paclitaxel-coated balloon catheter in bifurcated coronary lesions (babilon trial): 24-month clinical and angiographic results. EuroIntervention 10:50–57

    Article  PubMed  Google Scholar 

  • Medina A, SuarezdeLezo J, Pan M (2006) A new classification of coronary bifurcation lesions. Rev Esp Cardiol 59:183

    Article  PubMed  Google Scholar 

  • Meier B (1984) Kissing balloon coronary angioplasty. Am J Cardiol 54:918–920

    Article  CAS  PubMed  Google Scholar 

  • Meier B, Gruentzig AR, King SB 3rd, Douglas JS Jr, Hollman J, Ischinger T, Aueron F, Galan K (1984) Risk of side branch occlusion during coronary angioplasty. Am J Cardiol 53:10–14

    Article  CAS  PubMed  Google Scholar 

  • Mintz GS, Weissman NJ (2006) Intravascular ultrasound in the drug-eluting stent era. J Am Coll Cardiol 48:421–429

    Article  PubMed  Google Scholar 

  • Moussa ID, Colombo A (2010) Coronary artery bifurcation interventions: bridging the gap between research and practice. In: Moussa ID, Colombo A (eds) Tips and tricks in interventional therapy of coronary bifurcation lesions. Informa Healthcare, London

    Chapter  Google Scholar 

  • Murray CD (1926) The physiological principle of minimum work: I. The vascular system and the cost of blood volume. Proc Natl Acad Sci U S A 12:207–214

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Niemela M, Kervinen K, Erglis A, Holm NR, Maeng M, Christiansen EH, Kumsars I, Jegere S, Dombrovskis A, Gunnes P, Stavnes S, Steigen TK, Trovik T, Eskola M, Vikman S, Romppanen H, Makikallio T, Hansen KN, Thayssen P, Aberge L, Jensen LO, Hervold A, Airaksinen J, Pietila M, Frobert O, Kellerth T, Ravkilde J, Aaroe J, Jensen JS, Helqvist S, Sjogren I, James S, Miettinen H, Lassen JF, Thuesen L (2011) Randomized comparison of final kissing balloon dilatation versus no final kissing balloon dilatation in patients with coronary bifurcation lesions treated with main vessel stenting: the Nordic-Baltic Bifurcation Study III. Circulation 123:79–86

    Article  PubMed  Google Scholar 

  • Onuma Y, Muller R, Ramcharitar S, van Geuns RJ, Louvard Y, Morel MA, Morice MC, Davis R, Kaplan AV, Lefevre T, Grube E, Serruys PW (2008) Tryton I, first-in-man (FIM) study: six month clinical and angiographic outcome, analysis with new quantitative coronary angiography dedicated for bifurcation lesions. EuroIntervention 3:546–552

    Article  PubMed  Google Scholar 

  • Ormiston J, Webster M, El-Jack S, McNab D, Plaumann SS (2007) The AST petal dedicated bifurcation stent: first-in-human experience. Catheter Cardiovasc Interv 70:335–340

    Article  PubMed  Google Scholar 

  • Ormiston JA, Lefevre T, Grube E, Allocco DJ, Dawkins KD (2010) First human use of the taxus petal paclitaxel-eluting bifurcation stent. EuroIntervention 6:46–53

    Article  PubMed  Google Scholar 

  • Pan M, de Lezo JS, Medina A, Romero M, Segura J, Pavlovic D, Delgado A, Ojeda S, Melian F, Herrador J, Urena I, Burgos L (2004) Rapamycin-eluting stents for the treatment of bifurcated coronary lesions: a randomized comparison of a simple versus complex strategy. Am Heart J 148:857–864

    Article  CAS  PubMed  Google Scholar 

  • Patel Y, Depta JP, Novak E, Yeung M, Lavine K, Banerjee S, Lin CH, Zajarias A, Kurz HI, Lasala JM, Bach RG, Singh J (2012) Long-term outcomes with use of intravascular ultrasound for the treatment of coronary bifurcation lesions. Am J Cardiol 109:960–965

    Article  PubMed  Google Scholar 

  • Prasad A, Gersh BJ, Bertrand ME, Lincoff AM, Moses JW, Ohman EM, White HD, Pocock SJ, McLaurin BT, Cox DA, Lansky AJ, Mehran R, Stone GW (2009) Prognostic significance of periprocedural versus spontaneously occurring myocardial infarction after percutaneous coronary intervention in patients with acute coronary syndromes: an analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial. J Am Coll Cardiol 54:477–486

    Article  PubMed  Google Scholar 

  • Renkin J, Wijns W, Hanet C, Michel X, Cosyns J, Col J (1991) Angioplasty of coronary bifurcation stenoses: immediate and long-term results of the protecting branch technique. Cathet Cardiovasc Diagn 22:167–173

    Article  CAS  PubMed  Google Scholar 

  • Routledge HC, Morice MC, Lefevre T, Garot P, De Marco F, Vaquerizo B, Louvard Y (2008) 2-year outcome of patients treated for bifurcation coronary disease with provisional side branch T-stenting using drug-eluting stents. JACC Cardiovasc Interv 1:358–365

    Article  PubMed  Google Scholar 

  • Russell ME, Binyamin G, Konstantino E (2009) Ex vivo analysis of human coronary bifurcation anatomy: defining the main vessel-to-side-branch transition zone. EuroIntervention 5:96–103

    Article  PubMed  Google Scholar 

  • Safian RD, Schreiber TL, Baim DS (1993) Specific indications for directional coronary atherectomy: origin left anterior descending coronary artery and bifurcation lesions. Am J Cardiol 72:35E–41E

    Article  CAS  PubMed  Google Scholar 

  • Scheller B, Fischer D, Clever YP, Kleber FX, Speck U, Bohm M, Cremers B (2013) Treatment of a coronary bifurcation lesion with drug-coated balloons: lumen enlargement and plaque modification after 6 months. Clin Res Cardiol 102:469–472

    Article  PubMed  Google Scholar 

  • Serruys PW, de Jaegere P, Kiemeneij F, Macaya C, Rutsch W, Heyndrickx G, Emanuelsson H, Marco J, Legrand V, Materne P et al (1994) A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. Benestent Study Group. N Engl J Med 331:489–495

    Article  CAS  PubMed  Google Scholar 

  • Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, van der Brand M, Dyck NV, Russell ME, Mohr FW, Serruys PW (2005) The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention 1:219–227

    PubMed  Google Scholar 

  • Stankovic G, Darremont O, Ferenc M, Hildick-Smith D, Louvard Y, Albiero R, Pan M, Lassen JF, Lefèvre T (2009) Percutaneous coronary intervention for bifurcation lesions: 2008 consensus document from the fourth meeting of the European Bifurcation Club. EuroIntervention 5(1):39–49

    Google Scholar 

  • Steigen TK, Maeng M, Wiseth R, Erglis A, Kumsars I, Narbute I, Gunnes P, Mannsverk J, Meyerdierks O, Rotevatn S, Niemela M, Kervinen K, Jensen JS, Galloe A, Nikus K, Vikman S, Ravkilde J, James S, Aaroe J, Ylitalo A, Helqvist S, Sjogren I, Thayssen P, Virtanen K, Puhakka M, Airaksinen J, Lassen JF, Thuesen L (2006) Randomized study on simple versus complex stenting of coronary artery bifurcation lesions: the Nordic bifurcation study. Circulation 114:1955–1961

    Article  PubMed  Google Scholar 

  • Takebayashi H, Haruta S, Kohno H, Ichinose H, Taniguchi M, Shimakura T, Ohe T (2004) Immediate and 3-month follow-up outcome after cutting balloon angioplasty for bifurcation lesions. J Interv Cardiol 17:1–7

    Article  PubMed  Google Scholar 

  • Tanigawa J, Barlis P, Di Mario C (2007) Intravascular optical coherence tomography: optimisation of image acquisition and quantitative assessment of stent strut apposition. EuroIntervention J EuroPCR Collab Work Group Interv Cardiol Eur Soc Cardiol 3:128–136

    Google Scholar 

  • Tsuchida K, Colombo A, Lefevre T, Oldroyd KG, Guetta V, Guagliumi G, von Scheidt W, Ruzyllo W, Hamm CW, Bressers M, Stoll HP, Wittebols K, Donohoe DJ, Serruys PW (2007) The clinical outcome of percutaneous treatment of bifurcation lesions in multivessel coronary artery disease with the sirolimus-eluting stent: insights from the Arterial Revascularization Therapies Study part II (ARTS II). Eur Heart J 28:433–442

    Article  PubMed  Google Scholar 

  • van der Giessen AG, Wentzel JJ, Meijboom WB, Mollet NR, van der Steen AF, van de Vosse FN, de Feyter PJ, Gijsen FJ (2009) Plaque and shear stress distribution in human coronary bifurcations: a multislice computed tomography study. EuroIntervention 4:654–661

    Article  PubMed  Google Scholar 

  • van der Waal EC, Mintz GS, Garcia-Garcia HM, Bui AB, Pehlivanova M, Girasis C, Serruys PW, van der Giessen WJ, Weissman NJ (2009) Intravascular ultrasound and 3D angle measurements of coronary bifurcations. Catheter Cardiovasc Interv 73:910–916

    Article  PubMed  Google Scholar 

  • Verheye S, Agostoni P, Dubois CL, Dens J, Ormiston J, Worthley S, Trauthen B, Hasegawa T, Koo BK, Fitzgerald PJ, Mehran R, Lansky AJ (2009a) 9-month clinical, angiographic, and intravascular ultrasound results of a prospective evaluation of the axxess self-expanding biolimus a9-eluting stent in coronary bifurcation lesions: the diverge (drug-eluting stent intervention for treating side branches effectively) study. J Am Coll Cardiol 53:1031–1039

    Article  PubMed  Google Scholar 

  • Verheye S, Grube E, Ramcharitar S, Schofer JJ, Witzenbichler B, Kovac J, Hauptmann KE, Agostoni P, Wiemer M, Lefevre T, Serruys PW, van Geuns RJ (2009b) First-in-man (FIM) study of the stentys bifurcation stent – 30 days results. EuroIntervention 4:566–571

    Article  PubMed  Google Scholar 

  • Vetrovec GW, Cowley MJ, Wolfgang TC, Ducey KC (1985) Effects of percutaneous transluminal coronary angioplasty on lesion-associated branches. Am Heart J 109:921–925

    Article  CAS  PubMed  Google Scholar 

  • Wong CB, Hardin S (2005) A novel technique for coronary bifurcation lesions: cutting balloons, drug-eluting stents and the kissing technique. J Invasive Cardiol 17:108–110

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Av. Dante Pazzanese 500, Ibirapuera, Sao Paulo, 04012-909, Brazil

    Ricardo A. Costa

  2. First Coast Cardiovascular Institute, 3900 University BLVD S, 32216, Jacksonville, FL, USA

    Issam D. Moussa

  3. UCF College of Medicine, 32816, Orlando, FL, USA

    Issam D. Moussa

Authors
  1. Ricardo A. Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Issam D. Moussa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ricardo A. Costa .

Editor information

Editors and Affiliations

  1. Division of Cardiovascular Disease Department of Internal Medicine, Health Care Center Bitterfeld, Bitterfeld-Wolfen, Germany

    Peter Lanzer

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Costa, R.A., Moussa, I.D. (2015). Interventional Treatments of Coronary Artery Bifurcations. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_74

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-37078-6_74

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-37077-9

  • Online ISBN: 978-3-642-37078-6

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation