Bifurcation lesions and the kissing‐device technique

Abstract

Juxtaposed "Kissing" stents as a technique to preserve both limbs of a renal artery bifurcation lesion is reported by Drs. Avula and Dorros in this issue of Carheferizarion and Cardiovascular Diagnosis.The technique to treat bifurcation lesions in peripheral arteries was introduced 16 years ago by Andreas Gruentzig for externalinternal iliac stenoses using two dilatation catheters in a procedure he termed "kissing-balloon" angioplasty. This technique was first Most coronary bifurcation lesions involve the left anterior descending and the diagonal branches. Fewer involve the left circumflex (91 and the right coronary [6,12] arteries. A classification scheme of coronary bifurcation morphology was proposed by George et al. in 1986 [ 5 ] .In the 1986 textbook "Angioplasty" [ 131, we presented several cases of bifurcation stenoses using the kissing balloon technique in the coronary and peripheral circulation; one case involved a renal bifurcation stenosis (Figure 1 ). This patient with renovascular hypertension and an abnormal renal scan had successful kissing balloon angioplasty via two renal guiding catheters introduced percutaneously via right and left femoral arterial sites. Through these guiding catheters, two coronary balloon catheters were advanced over coronary guidewires. Successful angioplasty was achieved and resulted in normalization of the renal scan and a normotensive status without antihypertensive treatment at 6 months followup.In 1993