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Related Concept Videos

Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

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Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
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Coronary Artery Disease V: Interprofessional Care01:27

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Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
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Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Coronary Artery Disease II: Pathophysiology01:26

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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Acute Coronary Syndrome I: Introduction01:30

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Cardiac Catheterization III: Left Heart Catheterization01:24

Cardiac Catheterization III: Left Heart Catheterization

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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Related Experiment Video

Updated: Jan 13, 2026

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Coronary Bifurcation PCI-Part I: Fundamentals.

Sara Pollanen1, Rongras Damrongwatanasuk2, Ju Young Bae3

  • 1Temerty Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada.

Journal of Cardiovascular Development and Disease
|October 28, 2025
PubMed
Summary

Percutaneous coronary intervention (PCI) for bifurcation lesions is complex. This review details techniques and strategies for successful PCI, focusing on preserving vessel patency and guiding interventional cardiologists.

Keywords:
bifurcation lesionsbifurcation stentingcoronary artery diseaseprimary coronary intervention

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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Area of Science:

  • Interventional Cardiology
  • Cardiovascular Surgery

Background:

  • Percutaneous coronary intervention (PCI) of bifurcation lesions presents significant technical challenges in interventional cardiology.
  • Optimal strategies are crucial for maintaining main vessel and side branch patency, with ongoing evolution in provisional versus two-stent approaches.

Purpose of the Study:

  • To provide a comprehensive narrative review of current knowledge on bifurcation PCI.
  • To serve as a practical, technique-focused reference for interventionalists and trainees managing complex coronary bifurcations.

Main Methods:

  • Synthesis of current scientific literature on bifurcation PCI.
  • Detailed description of anatomical classifications, lesion assessment, and procedural planning.
  • In-depth explanation of techniques such as T and Protrusion (TAP), double-kissing (DK) crush, mini-crush, culotte, and V-stent.

Main Results:

  • The review outlines various techniques for bifurcation PCI, including established and emerging modifications.
  • It emphasizes the importance of tailoring strategy selection based on lesion complexity, procedural objectives, and patient factors.
  • The choice between provisional and two-stent strategies is contextualized within these considerations.

Conclusions:

  • Effective management of bifurcation lesions requires careful planning and precise execution of chosen PCI techniques.
  • This review serves as a foundational resource for interventional cardiologists seeking to enhance their skills in complex bifurcation interventions.
  • The selection of the optimal PCI strategy is multifactorial, integrating anatomical, procedural, and patient-specific elements.