ZEL BFURKASYON STENTLER Dedicated stents for bifurca@ons

Ylmaz Nianc

Dedicated Bifurca-on Devices

Bifurca-on Op-miza-on Stent System -

BIOSS

BIOSS Stent

Balon i-kten sonra,distal ve proksimal aplarna uyan, 2 blml stent. (POT efek- gibi). Karina kaymasn engelliyor.

No dierence in clinical parametres with BIOSS vs DES

ABBOT DES, yan dal girili bifurkasyon sistemi (ABT Fron-er)

Aldnda yan dal os@umunu tam kaplayacak. Kendi alr, ni@nol, BMS

COBRA trial

Primer son nokta : OCT ile, bifurkasyonun kaplanmama derecesi: 9 ayda CULOTTE TEKN DAHA Y GRLYOR.

COBRA trial

self expandable, ni@nol, BMS ve DES (paclitaxel) li, stabil polimerli 6F e uygun tek telli (wire) AYRILABLR STRUT lardan yan dala gei kolay. SB Os@umunu kaplamas mkemmel

SONU

zel yan dal stentleri : Bifurkasyon stentlerine ih@ya vardr. lemi kolaylaarrlar, akut baar sonucunu arbrrlar.

Uygun yaplm bifurkasyon stentleme ynlemlerine stnln gsteren yeterli uygulama ve veri yoktur.

Anakoroner bifurkasyonlarnda yarar daha fazla olabilir.

Stent specica-ons for LM PCI

6. Keep it simple: And fast BVS: 2 atm per 5 seconds + 30 sec at max Pressure For 16 atm: 40 + 30 sec: 70 seconds.

BVS requires aggressive predilata@on with increased risk of dissec@ons BVS requires postdilata@on in calcied lesions

BVS in LM is possible

1. Anatomy suited for single scaold cross-over 2. Able to tolerate prolonged ina@on @mes : . Absence of severe heart failure

3. Diameter

BVS in bifurca-on

TAP technique is reasonable BVS in MV and DES in side branch Final kissing ?

DEB in Bifurca-ons

Conclusions DEB only strategy is eec@ve in Medina 0-1-1 bifurca@ons DEB only strategy is possible in the majority of such

lesions Sten@ng might be avoidable in many pa@ents without an increase in restenosis and MACE rate The DEB only approach should be inves@gated in larger series of pa@ents

IVUS-guided treatment of complex bifurca-on lesions is associated with signicantly lower rates of adverse cardiac events at late follow-up

Bifurca@on lesions, propensity score matching (n=247 / n=202) ACS 61% and 89% of bifurca@ons lesions were Medina class 1,1,1 IVUS compared to no IVUS was associated with signicantly lower

rates of death or MI (OR 0.38, 95% CI 0.20 to 0.74, p = 0.005), death (OR 0.40, 95% CI 0.18 to 0.88, p = 0.02), MI (OR 0.37, 95% CI 0.14 to 0.98, p = 0.04), periprocedural MI (OR 0.45, 95% CI 0.20 to 0.97, p = 0.04), TVR (OR 0.28, 95% CI 0.14 to 0.53, p

Bifurkasyon stentlemede 2 stent yerle-rme yaklam