16.2 Provisional bifurcation stenting - Manual of PCI

Step-by-step description of the provisional bifurcation stenting technique and troubleshooting.

[@matheuscsmed]

Thank you, Matheus Silva

[@tom11298]

Great overview, and best simply explained PS manual ever. appreciate your efforts.

[@adilakshmib6181]

Very nice demonstration of cases n teaching. Thank you very much

[@alecandreva]

great overlook, definitely one of my favorites! looking forward for the pci manual coming soon! epharisto!

[@123miltos]

Πολύ καλή ανάλυση ! Ευχαριστούμε !

[@ahmedsabbar9049]

Thank u very much for your priceless educational efforts

[@hakimhadjouni5492]

Thank you so much

[@heartwork8373]

Thanks a lot!!!

[@MuhammadSulemankmc]

Jailing a good size SB can lead to lifelong exposure of stent struts unless we open them with POT-kiss-POT or POT-side-POT technique. European Bifurcation club consensus document recommends this technique in provisional stenting of bifurcation lesion with good size SB.

[@n9pq54]

Hello How can I get your book? PDF or Hardcopy?

[@meti1985]

Very nice Cases Sir. In the reverse Crush Technique, did you jail the SB Wire after the SB Stent crush? Is there a Risk of pinching the SB Wire between two Stents (MB an crushed SB Stent).

[@Ahmedashraf007]

i have one comment sir ...... why didnot you use the iFR at 1st for assesment of the bifurcation lesion ? .......2nd if you used the ivus already for the primary assesment , why didnt you use it again for the assesment of the side branch lesion severity post POT , or you just prefferred to use the iFR to leave the lesion ??

[@dobryi_chel]

Thank you professor for the next informative case. In your examples, I often see hemodynamic support, like an impella. This implies a patient with low ejection fractions. Does revascularization in patients with low fractions help to raise the ejection fraction? According to my observations, the ejection fraction remains unchanged even after revascularization. I meen EF low than 25%.

[@manosbrilakis]

Excellent points, thank you. Recovery of left ventricular function depends on many factors, the most important of which is viability. Therefore, viability testing is important in cardiomyopathy patients. Moreover, revascularization should be successsful. Finally, it may take several months for left ventricular function to recover.

[@BarrieLouis]

There is published "Wolff et all" meta analysis which showed advantage of stenting vs OMT in patients with severe heart failure. So I thing revascularization does always have sense (in cases of proved viability)

[@duytanlam3060]

Thank Sir! Could you share handout!

[@farukakturk5388]

Sir, Do you reccomend this tech. at LMCA lesions 1.1.0 (Lcx as Side branch).

[@manosbrilakis]

In most cases yes, but it depends on the complexity of the left main and proximal LAD disease. If there is an eccentric, thrombotic, or heavily calcified lesions two stents may be required.

[@farukakturk5388]

@@manosbrilakis Thank you very much