Abstract

DOUBLE AND SINGLE STENT MANAGEMENT IN BIFURCATION CORONARY ARTERIES IRAQ

*Dr. Kamaran Khalil Ibrahim, Dr. Muthanna Mustafa Hussein, Dr. Mustafa Kadban Mohammed

ABSTRACT

Coronary bifurcation lesions account for 15–20% of all coronary lesions that require percutaneous coronary intervention (PCI).[1] Bifurcation stenosis is one of the most complex coronary lesions requiring endovascular treatment because the lumen of both the main vessel and the side branch needs to be restored. The best approach for the management of a bifurcation to achieve optimal procedural outcomes and, more importantly, long-term success with low restenosis rates and low major adverse clinical event (MACE) rates is still debated. Balloon angioplasty alone to treat bifurcation lesions has resulted in relatively low angiographic success and high restenosis rates.[2,3] Although the introduction of bare-metal stents (BMSs) resulted in more predictable results and higher success rates, angiographic restenosis rates still remained high. The introduction of drug-eluting stents (DESs) in clinical practice has altered the treatment perspective when dealing with this type of lesion; however, abrupt side-branch closure with the single-stent strategies, together with the risk of thrombosis and restenosis associated with the complex two-stent techniques, remains a predictor of adverse clinical outcomes.

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