Double Bifurcation Optimization Stent System Technique for Left Main Stenosis

Abstract

We present a first-in-man case with implantation in culottes' fashion of two dedicated coronary bifurcation stents (BiOSS Lim) in distal left main stenosis. The immediate procedural and very short-term result was excellent.

The approach to coronary bifurcation treatment and its outcomes in Poland: The single center experience

“…The main findings of this study are: 1) coronary bifurcations were mainly treated with 1 stent (PTS OR -odds ratio; CI -confidence interval; DES -drug eluting stents; NSTE-ACS -non-ST-elevation acute coronary syndrome; MI -myocardial infarction; PCI -percutaneous coronary intervention; LM -left main; MV -main vessel; SB -side branch strategy), 2) 1-year MACE and TLR rates were 11.2% and 7.9%, respectively, 3) clinical outcomes for dedicated bifurcation stents BiOSS and regular DES were similar, 4) optimization techniques (FKB, POT) were rarely used. In this study the population was severely diseased, with rates of diabetes (28.3%), prior MI (42.8%) and prior PCI (44.7%) which is higher than in other studies assessing bifurcation treatment, 11-25.7%, 19.5-46% and 11.3-37.1% [13][14][15][16][17] respectively.…”

“…Only 10 cases required a two-stent technique, mainly performed with TAP and culotte. Worth stressing is the fact that all culotte procedures were performed in distal left main with the deployment of two BiOSS LIM ® stents as described previously [17].…”

A Case Summary of the Application of a Drug-Eluting Stent Combined with a Drug-Coated Balloon in Left Main Coronary Artery Disease

“…For LM true bifurcation lesions, the current PCI therapy in clinical settings is still primarily singlestenting or double-stenting intervention, but these two methods do not reduce the incidence of in-stent restenosis, possibly due to factors such as vascular anatomy (the proximal lesion involves longer vessel length and a wider angle of division), hemodynamics (large local blood flow), stent deformation, and reduced drug coverage [19][20][21][22]. Among these, stent thrombosis after single stenting may be caused by the protrusion of stent struts in the bifurcation lesion [23], and single stenting applies only for stent placement in the LM or LAD, while the LCX will be subject to plaque compression after stenting to various degrees, resulting in aggravated stenosis, which might eventually lead to total LCX occlusion.…”

BiOSS® Clinical Programme – State Of The Art – BiOSS LIM® Stent – The Novel Option For Coronary Bifurcation Treatment

“…7 Also, its ease-of-use allows the implantation of two BiOSS LIM ® stents in a culottes fashion in distal LM stenosis. 8 Since the beginning, the BiOSS LIM ® stent construction provoked the question whether a 2.0-2.4 mm long middle zone of that stent was the weakest part predisposing to restenosis and intrastent thrombosis.…”