2022
DOI: 10.1097/cd9.0000000000000064
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Provisional Stenting: A Contemporary Relook at the Strategy and Lingering Issues

Abstract: Bifurcation lesions are encountered and treated in up to 1 in 5 cases of percutaneous coronary intervention (PCI). Such lesions pose a technical challenge to PCI, leading to lower procedural success and a higher rate of long-term adverse events. However, each bifurcation is unique in terms of anatomy and pathological presentation. There is no "one size fits all" strategy for coronary bifurcation PCI. Nevertheless, in most scenarios, provisional stenting is the preferred technique. This method is easy to apply … Show more

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Cited by 3 publications
(3 citation statements)
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“…This strategy starts with stent implantation in 1 branch and implantation of a second stent in the other branch only if indicated. [5] In a review article of this issue, Choo and Gurupparan [6] (Cardiac Vascular Sentral Kuala Lumpur, Malaysia) describe the key steps of the provisional stenting approach. However, release of the main-vessel stent often causes side branch occlusion because of shifting of the main-branch plaque or a change in the location of the carina, which leads to potentially fatal arrhythmias and perioperative myocardial infarction.…”
Section: Stenting Strategies For Cblsmentioning
confidence: 99%
“…This strategy starts with stent implantation in 1 branch and implantation of a second stent in the other branch only if indicated. [5] In a review article of this issue, Choo and Gurupparan [6] (Cardiac Vascular Sentral Kuala Lumpur, Malaysia) describe the key steps of the provisional stenting approach. However, release of the main-vessel stent often causes side branch occlusion because of shifting of the main-branch plaque or a change in the location of the carina, which leads to potentially fatal arrhythmias and perioperative myocardial infarction.…”
Section: Stenting Strategies For Cblsmentioning
confidence: 99%
“…Although the relatively high blood flow rates in these areas prevent atheroma development in the carina, plaques develop opposite to the carina owing to reduced endothelial shear stress [6]. As these lesions may have highly variable anatomies, structures, pathological conditions, and severities, no single strategy is applicable to their treatment [5] [7].…”
Section: Introductionmentioning
confidence: 99%
“…The appropriate technique for upfront double stenting is selected based on the anatomy and complexity of the lesion [7]. However, there is no agreement on a standard management technique for CBLs in which the application of second generation DESs does not improve outcomes after PCI [11].…”
Section: Introductionmentioning
confidence: 99%