Lesões coronarianas de bifurcação: classificação, estratégias de tratamento e perspectivas

Abstract

SUMMARY Coronary Bifurcation Lesions: Classification, Strategies of Treatment and PerspectivesThe occurrence of coronary lesions that involve side branches, with greater or lesser risk of occlusion, is not a rare event.The percutaneous treatment of these bifurcation lesions is a challenge to interventional cardiology. Their extremely varied presentation, whether due to the arrangement of the branches, or to the plaque distribution in the branches, has resulted in the description of several classifications. When coronary angioplasty was performed only with balloon catheters, many techniques were described. Results at follow up were unsatisfactory. After the introduction of stents, other strategies, using one or two stents, were described. However, the rates of target lesion revascularization remained high. Although, the use of drug-eluting stents has shown better results than bare metal stents, they are not totally convincing yet, especially in regards to the occurrence of restenosis at the ostia of side branches. Despite of not being a new idea, other models of stents specially designed for the treatment of bifurcation lesions, called dedicated stents, are being tested and some are already on the market.