Expert review

Bifurcated stents: giving to Caesar what is Caesar's


Alexandre Abizaid
Alexandre Abizaid*, MD, PhD; Jose de Ribamar Costa Jr., MD; Víctor Julio Alfaro, MD; Fausto Feres, MD, PhD; Rodolfo Staico, MD; Luis Alberto P. Mattos, MD; PhD; Galo Maldonado, MD; J. Eduardo Sousa, MD, PhD
Institute Dante Pazzanese of Cardiology, Av. Dr Dante Pazzanese, 500, Sao Paulo 04012, Brazil
Since its earlier days, procedural and technical difficulties allied to poor immediate and long-term outcomes have turned the percutaneous treatment of bifurcated coronary lesions into one of the most challenging scenarios of interventional cardiology1,2.

In the mid 1980’s, when balloon angioplasty was the standard percutaneous approach, the treatment of bifurcation lesions was considered a procedure of exception for carrying a high risk of acute ischaemic complications (e.g. acute coronary thrombosis) and restenosis. Usually, kissing-balloon was the preferred technique to minimise plaque shift to the side branch and improve immediate outcomes3,4.

In the early 1990’s, the use athero-ablative ...

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