Distal left main trifurcation disease in a patient with porcelain aorta

López-Peña, Ulises; García-García, Francisco; Robledo-Nolasco, Rogelio; Fernández-Ceseña, Ernesto; Borrego-Montoya, Ricardo; Morales, N. Ruiz

doi:10.1016/j.carrev.2017.03.001

Cited by 2 publications

(3 citation statements)

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“…Intervention for a trifurcation lesion is more complicated, requiring more wires and various complex interventional techniques [28]. Studies have shown an increase in periprocedural complications (dissection, acute side branch occlusion, periprocedural myocardial infarction) in trifurcation diseases [29,30]. Among the 84 patients who underwent LMCA-LAD Fig.…”

Section: Discussionmentioning

confidence: 99%

Role of IVUS in the rectification of angiographically judged ramus intermedius and its clinical significance

Gong

Huang

Sun

et al. 2021

BMC Cardiovasc Disord

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Background Due to the technical limitations of coronary artery angiography (CAG), ramus intermedius (RI) is sometimes difficult to distinguish from a high-origin obtuse marginal branch or a high-origin diagonal branch. This study sought to investigate the role of intravascular ultrasonography (IVUS) in the rectification of angiographically judged RI. Methods This study retrospectively analyzed 165 patients who were reported to have an RI based on CAG and underwent IVUS implementation from 02/01/2009 to 31/12/2019 in Zhongshan Hospital, Fudan University. Taking IVUS as the gold standard, we calculated the accuracy of RI identification by CAG and evaluated the impact of RI on revascularization strategy. Results Among the 165 patients, 89 patients (54%) were demonstrated to have an RI on IVUS (IVUS-RI), 32 patients (19%) were identified to have a high-origin diagonal branch on IVUS (IVUS-h-D), and 44 patients (27%) had an actual high-origin obtuse marginal artery on IVUS (IVUS-h-OM). Among 84 patients who underwent one-stent crossover stenting because of left main furcation lesions (48 patients in the IVUS-RI group, 12 patients in the IVUS-h-D group, and 24 in the IVUS-h-OM group), 14.6% of patients in the IVUS-RI group, 33.3% in the IVUS-h-D group and 0% in the IVUS-h-OM group had CAG-RI compromise (P = 0.02), which was defined as severe stenosis of the RI ostium (> 75%) or significant RI flow impairment (TIMI < 3). Conclusions Only 54% of CAG-RIs were confirmed by IVUS, which indicates the necessity of preintervention IVUS to distinguish real RIs from other branches in LM furcation lesions.

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Section: Discussionmentioning

confidence: 99%

Role of IVUS in the rectification of angiographically judged ramus intermedius and its clinical significance

Gong

Huang

Sun

et al. 2021

BMC Cardiovasc Disord

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“…Therefore, efforts to reduce the risk of temporary or chronic side branch occlusion during PCI are crucial. In addition, PCI is more complex for coronary trifurcation than for bifurcation lesions [ 10 – 13 ]. Although coronary artery bypass grafting surgery is generally recommended for patients with left main trifurcation disease, especially those with ostial plaque involvement of side branches, PCI may sometimes be required in selected patients with acute coronary syndrome at presentation and intolerance of or refusal to undergo a surgical approach mainly because of old age or systemic comorbidities [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…To overcome these difficulties associated with PCI for bifurcation lesions, the jailed balloon technique and jailed Corsair technique have been established [ 3 – 9 ]. Although these techniques are useful, PCI is more complex for coronary trifurcation than bifurcation lesions [ 10 – 13 ], and little is known regarding the application and feasibility of these side branch protection techniques for left main trifurcation disease. We herein describe a 72-year-old man with angina pectoris who was successfully treated with percutaneous coronary stent implantation for a left main trifurcation lesion using the simultaneous jailed balloon and jailed Corsair technique.…”

Section: Introductionmentioning

confidence: 99%

A Novel Double Side Branch Protection Technique for a Left Main Trifurcation Lesion: Simultaneous Jailed Balloon and Jailed Corsair Technique

Munakata

Numasawa

Ishikawa

et al. 2018

Case Reports in Cardiology

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Percutaneous coronary intervention for left main trifurcation disease is challenging. Although side branch protection techniques such as the jailed balloon technique and jailed Corsair technique are the established methods for treatment of coronary bifurcation lesions, little is known regarding the application and feasibility of these techniques for left main trifurcation disease. We herein describe a 72-year-old man with angina pectoris who was successfully treated with percutaneous coronary stent implantation for a left main trifurcation lesion. In this case, we performed a novel double side branch protection technique, the simultaneous jailed balloon and jailed Corsair technique, with a single 8 Fr guiding catheter. This is the first case report to highlight the feasibility and efficacy of combined use of the jailed balloon and jailed Corsair techniques during percutaneous coronary intervention for left main trifurcation disease.

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Distal left main trifurcation disease in a patient with porcelain aorta

Cited by 2 publications

References 10 publications

Role of IVUS in the rectification of angiographically judged ramus intermedius and its clinical significance

Role of IVUS in the rectification of angiographically judged ramus intermedius and its clinical significance

A Novel Double Side Branch Protection Technique for a Left Main Trifurcation Lesion: Simultaneous Jailed Balloon and Jailed Corsair Technique

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