The side branch ostium: understanding the Achilles heel of treating bifurcation coronary disease.
Angioplasty of lesions involving a bifurcation remains one of the most challenging lesion subsets in the field of coronary intervention. A general approach to dealing with bifurcation lesions is to avoid intervention of the side branch (SB) if possible. Angiographic or flow criteria are used to determine SB intervention; however, angiographic evaluation alone can be inaccurate. Performing intravascular ultrasound prior to intervention is a useful strategy. This aids the interventional cardiologist in determining whether main branch stenting alone is sufficient or if stenting of the SB is also warranted.
Bekdash
Ismail L
IL
Department of Cardiology, Geisinger Health System, Danville, PA, USA.
Hodgson
John McB
JM
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D018579:Patient Selection; D018570:Risk Assessment; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional