TY - JOUR
T1 - Practice Patterns in the Interventional Treatment of Coronary Bifurcation Lesions
T2 - A Global Survey
AU - Nikolakopoulos, Ilias
AU - Vemmou, Evangelia
AU - Karacsonyi, Judit
AU - Azzalini, Lorenzo
AU - Bergmark, Brian A.
AU - Chatzizisis, Yiannis S.
AU - Hall, Allison B.
AU - Wollmuth, Jason
AU - Croce, Kevin
AU - Jneid, Hani
AU - Rangan, Bavana V.
AU - Burke, M. Nicholas
AU - Brilakis, Emmanouil S.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - OBJECTIVES: The study aim was to assess current procedural strategies and perceptions for percutaneous coronary intervention (PCI) involving bifurcations. METHODS: We distributed an online survey via email (8050 invitations) and social media. RESULTS: Among 440 responders, median annual PCI volumes were 15 cases (interquartile range [IQR], 10-29 cases) for left main (LM) and 50 cases (IQR, 27-73 cases) for non-LM (nLM) bifurcation lesions. Radial access use was reported in 51% of LM and 82% of nLM cases. An upfront 2-stent strategy, most commonly double-kissing (DK) crush, was reported in 49% of LM and 29% of nLM lesions. Bailout stenting during provisional stenting was reported in 26% of LM-PCIs, usually using the T and protrusion technique. In provisional stenting cases, most operators (<35%) did not report predilating the side branch, but routinely postdilated after successful provisional stenting (>85%), most often using both kissing-balloon inflation and the proximal optimization technique. Intravascular imaging was used in 80% of LM and 46% of nLM cases. CONCLUSIONS: Among the survey responders, the DK crush technique was the most frequently used 2-stent strategy for bifurcation PCIs. For LM lesions, bailout stenting was performed after provisional strategy in approximately 25% of cases. For nLM lesions, use of intravascular imaging and coronary physiology was lower than for LM lesions.
AB - OBJECTIVES: The study aim was to assess current procedural strategies and perceptions for percutaneous coronary intervention (PCI) involving bifurcations. METHODS: We distributed an online survey via email (8050 invitations) and social media. RESULTS: Among 440 responders, median annual PCI volumes were 15 cases (interquartile range [IQR], 10-29 cases) for left main (LM) and 50 cases (IQR, 27-73 cases) for non-LM (nLM) bifurcation lesions. Radial access use was reported in 51% of LM and 82% of nLM cases. An upfront 2-stent strategy, most commonly double-kissing (DK) crush, was reported in 49% of LM and 29% of nLM lesions. Bailout stenting during provisional stenting was reported in 26% of LM-PCIs, usually using the T and protrusion technique. In provisional stenting cases, most operators (<35%) did not report predilating the side branch, but routinely postdilated after successful provisional stenting (>85%), most often using both kissing-balloon inflation and the proximal optimization technique. Intravascular imaging was used in 80% of LM and 46% of nLM cases. CONCLUSIONS: Among the survey responders, the DK crush technique was the most frequently used 2-stent strategy for bifurcation PCIs. For LM lesions, bailout stenting was performed after provisional strategy in approximately 25% of cases. For nLM lesions, use of intravascular imaging and coronary physiology was lower than for LM lesions.
KW - percutaneous coronary intervention
KW - radial access
KW - two-stent strategy
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M3 - Article
C2 - 34982725
AN - SCOPUS:85123229137
SN - 1042-3931
VL - 34
SP - E43-E48
JO - The Journal of invasive cardiology
JF - The Journal of invasive cardiology
IS - 1
ER -