title: Inverted crush technique for uncrossable side branch occlusion during provisional side branch stenting: a new role for the jailed wire.
abstract: Provisional side-branch stenting is currently the most widely accepted percutaneous technique for the treatment of bifurcation lesions. However, abrupt closure of the side branch may occur after main vessel stent implantation. Resolving side-branch stenosis under these conditions may pose major technical difficulties. We describe a new technique to resolve uncrossable side-branch occlusion following main-vessel stent implantation during provisional side-branch stenting. The technique consists of using the jailed wire to dilate the occluded side branch. We first use a low profile, 1.25-mm diameter balloon catheter. A regular balloon is then inflated through the same wire to open the side branch, crushing the proximal part of the main vessel stent. At this point, a second stent is implanted at the side-branch, finishing the procedure as an inverted crush stenting. The described strategy may be useful in cases of uncrossable side-branch occlusion causing severe hemodynamic impairment that cannot be swiftly managed with conventional methods.
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain. manuelpan@telefonica.net
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.forename: Miguel
authors.initials: M
authors.lastname: Romero
authors.forename: Soledad
authors.initials: S
authors.lastname: Ojeda
authors.forename: Jose
authors.initials: J
authors.lastname: Segura
authors.forename: Francisco
authors.initials: F
authors.lastname: Mazuelos
authors.forename: Javier
authors.initials: J
authors.lastname: Suárez de Lezo
authors.forename: Alfonso
authors.initials: A
authors.lastname: Medina
authors.forename: Jose
authors.initials: J
authors.lastname: Suárez de Lezo
mesh_terms: D000368:Aged; D002404:Catheterization; D023921:Coronary Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods