IMR Press / RCM / Volume 24 / Issue 9 / DOI: 10.31083/j.rcm2409266
Open Access Review
DES Selection for Left Main and Coronary Bifurcation Stenting
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1 Department of Cardiology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
2 Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
*Correspondence: gorastan@gmail.com (Goran Stanković)
Rev. Cardiovasc. Med. 2023, 24(9), 266; https://doi.org/10.31083/j.rcm2409266
Submitted: 16 April 2023 | Revised: 10 May 2023 | Accepted: 1 June 2023 | Published: 21 September 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Coronary bifurcation lesions present a challenging lesion subset regarding procedural complexity and worse patient outcomes as compared to simple lesions. Drug eluting stents (DES), as the current standard of care for percutaneous myocardial revascularization, have tubular design and uniform diameter, and therefore, need to be subjected to a standardized set of procedural modifications, to optimally fit and reconstruct underlying bifurcation anatomy. Since contemporary DES have various design platforms, with diverse mechanical properties, we must be aware of the device’s favorable characteristics and limitations, to ensure maximal procedural safety and success. This is especially true for bifurcation lesion stenting, during which device integrity will often be eventually tested by undergoing specific procedural steps, such as proximal balloon optimization, kissing-balloon inflations, or even intentional stent crushing. In this review we address the design characteristics of contemporary DES, their bifurcation-specific experimental testing data, and reported clinical results, in an attempt to provide relevant information and help in device selection for bifurcation stenting procedures.

Keywords
drug-eluting stents
bifurcation stenting
left main coronary artery
device selection
device bench testing
Figures
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