Context: The T-stenting with small protrusion (TAP) technique is a relatively new strategy among the bifurcation lesion interventions. Apart from being technically easy, there is complete coverage of the side-branch ostium and minimal overlap of the stent struts. Aims: We sought to report the outcomes of TAP technique in the management of the bifurcation lesions. Settings and Design: Prospective observational study between December 2017 and December 2019. Subjects and Methods: Patients with a diagnosis of coronary artery disease and bifurcation lesion on angiography were included in the study. Patients who underwent intervention with TAP technique were analyzed at baseline and followed up for a period of 1 year. The measured endpoints include major adverse cardiac events (MACE), target vessel revascularization (TVR), stent thrombosis (ST), and binary restenosis at 1-year follow-up. Results: During the study period, 152 bifurcation lesions in 148 patients were treated by percutaneous coronary intervention using drug-eluting stents. Of these, 15 patients (10.13%) underwent TAP stenting. The median age was 60 years. The procedural success was 100% in all the patients. At 1-year follow-up, MACE was seen in 13.3%, TVR in 6.66%, and binary stenosis in 6.66%. Conclusion: The TAP stenting as an initial two-stent strategy is associated with acceptable clinical outcomes (MACE and in-stent restenosis). There was no case of definite ST.

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BACKGROUND Cardiac syndrome X (CSX) is not benign, and it needs long-term follow up and risk factor modification. In this study, we wanted to calculate microcirculatory transit time on coronary angiography in patients with cardiac syndrome X (CSX), compare microcirculatory transit time in patients with and without CSX and to see whether microcirculatory transit time can be proposed as a risk stratification method in CSX. METHODS Cross sectional study of 52 patients. The angiogram was taken at 15 frames per second. The left coronary artery was injected with 7 ml of contrast approximately. Microcirculatory transit time (MCTT) was obtained offline. The microcirculatory transit time in seconds is calculated as last frame count minus first frame count/15. Microcirculatory transit time was compared and analysed in both groups. RESULTS A total of 52 subjects were analysed. There were 26 cases in the angina group with a mean age of 49.96 years and 26 cases in the control group with a mean age of 50.32 years. Dyslipidemia, smoking and statin use were more common in the angina group, which was statistically significant (P < 0.05). The mean MCTT of the group with angina and positive treadmill test (TMT) was 6.76 seconds, whereas the negative TMT group was 6.39 seconds. The mean frame count was 58.1, and the mean MCTT was 3.8 seconds in the control group, whereas the mean frame count and mean MCTT were 98.1 and 6.5 seconds in the angina group, which was statistically significant (P < 0.001). CONCLUSIONS CSX patients had longer MCTT than patients without chest pain and normal coronary arteries. MCTT can be used to assess the risks of CSX. Long-term followup studies with a large sample size should be conducted. KEYWORDS Cardiac Syndrome X, Angina, Coronary Artery Disease, Microcirculation

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