16.1 Bifurcation PCI step-by-step - Manual of PCI

Step-by-step description of how to perform PCI of coronary bifurcation lesions.

[@marwanalsabri3790]

Great job 👏🏻 you are talented with your series of excellent lectures

[@jwilson3985]

Thank you much Dr Brilakis. Posted that stent expansion chart in our labs. 🙏🏻

[@tom11298]

best content when it comes to PCI. Thanks

[@mohammedsaif3551]

God bless you .Really amazing .Thank you

[@drewburton2587]

Thanks for your excellent videos. looking forward to upcoming book

[@karimgh2054]

Thanks sir .. very nice and interesting 👏👏

[@onlyredpoppy]

We can not thank you enough. God bless you.

[@shangz0216]

Thanks for your educative presentation.

[@matheuscsmed]

Thank you, Matheus Silva

[@wbcjunior]

Thank You, sir

[@seafly007]

Awesome thank u very much

[@phamhieu937]

Thanks you so much

[@user-di2sx1ll1i]

Thank you very much, very beneficial information. My English is not well. I have trouble understanding videos sometimes. Can you put subtitles in English please?

[@afsanehmohammadi9226]

Very helpful

[@llacielona]

awesome as usual! I find it sometime difficult to decide whether the side branch needs to be stented or not, for example a long diagonal brach with a diffuse disease but a vessel less 2mm or less. What is your approach? Do you stent vessels of 2 mm or less? what about the use of DEB? could that be an option in such cases?

[@manosbrilakis]

Usually do not stent small vessels, in most cases provisional work. If patient develops ischemia after jailing, balloon angioplasty usually suffices. DCBs are not approved for clinical use in the US but they seem to be highly promising for treating the side branch of bifurcation lesions.

[@dobryi_chel]

Thank You so much professor! When performing bifurcation stenting, in particular when performing kissing baloons technique, the wires inside the vessel are often intertwined. What recommendations can you give?

[@manosbrilakis]

If the wires are intertwined and equipment cannot be advanced, would remove the wire from the easier to wire vessel and rewire.

[@salahuddinsalahuddin3210]

Thanks. Just one question. When doing a "POT" in our lab, we just pull the stent-balloon back and do the POT with the stent-balloon. Is there any serious problem with such a technique? Or do we have to use a special balloon such as a NC-balloon? Thanks in advance for your answer.

[@ashutoshyadav7942]

We cannot use the same ballon. First reason is that it will also dilate the distal MV leading to carina shift. Second reason is that it can cause dissection in the unstented part of the proximal MV. However it can be done in LM Ostia lesions, if the entire stent ballon in pulled in LM and no part lies in LAD.

[@BWMcT]

Excellent presentation. How often do you have trouble retrieving jailed wires? What would you do if you cannot retrieve it?

[@manosbrilakis]

It is uncommon to have difficulty retrieving jailed wires. When it happens I do not pull hard - instead I advance a microcatheter or balloon as far as possible and then withdraw the wire.

[@doctorcardio3886]

Are you sure the ideal DIAMETERS should be 10,7 and 6? (23:10)

[@wbcjunior]

how to make Kissing balloons without errors? how to choose the balloons and which sequence to inflate the balloons?

[@manosbrilakis]

Balloon sizing is based on Finet's law: effective diameter of 2 balloons inflated side by side is (diameter of balloo 1 + diameter of balloon 2) x 2/3. Will typically do 2 step-kiss: high pressure (20+ atm) of the side branch balloon first, then lower pressure to 10-12 atm followed by inflation of the main vessel balloon at the same pressure. Will deflate balloons simultaneously.

[@ONF2000]

L

[@celaloz5973]

Thank you very much, very beneficial information.My English is not well.I have trouble understanding videos sometimes.Can you put subtitles in English please?

[@user-di2sx1ll1i]

And i