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TECHNIQUE CROSSOVER IN STENTING CORONARY BIFURCATION.

Sandra Šarić1,2, Marin Vučković1

  • 1Department of Cardiology, Osijek University Hospital Centre, Osijek, Croatia.

Acta Clinica Croatica
|July 2, 2025
PubMed
Summary

Percutaneous coronary intervention (PCI) for complex bifurcation lesions requires careful planning. A case study shows a shift from provisional stenting to a two-stent Culotte technique due to dissection, highlighting strategy adaptation in PCI.

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Area of Science:

  • Interventional Cardiology
  • Cardiovascular Surgery
  • Medical Device Technology

Background:

  • Percutaneous coronary intervention (PCI) for coronary artery disease often involves complex bifurcation lesions.
  • Choosing between one or two stent techniques is critical for procedural safety and long-term outcomes.
  • Provisional stenting is generally recommended for most bifurcation lesions.

Observation:

  • A patient presented with a bifurcation lesion in the left anterior descending artery (LAD) and first diagonal (D1).
  • The initial strategy involved provisional stenting of the LAD with a drug-coated balloon (DCB) for the D1 branch.
  • A dissection complication occurred in the LAD after the initial stenting procedure.

Findings:

  • The complication necessitated a change in procedural strategy from provisional stenting to a two-stent technique.
Keywords:
Bifurcation lesionsCulottebifurcation techniquesone-stent techniquetwo-stent technique

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  • The Culotte technique was employed as the alternative two-stent approach.
  • This case demonstrates the need for adaptability in PCI strategies when complications arise.

    • Implications:

    • Complex bifurcation PCI requires flexible strategies to manage unexpected complications.
    • The Culotte technique can be a viable alternative when provisional stenting fails.
    • Adapting PCI techniques is crucial for optimizing patient outcomes in challenging cases.