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Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
Bifurcation stenting
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Bifurcation stenting

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dr awadhesh

dr awadhesh

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  • 1. CASES OF BIFURCATIONSTENTING LAST WEEK
  • 2. WASIQ 47YRS/M R/O DELHI Chief c/o- 1-AOE NYHA class II for 2yrsh/o HTN, No h/o DMchronic bidi smokerECG- T wave inversion in V1-V62D ECHO- No RWMA,LVEF 60%
  • 3. BIFURCATION STENTING
  • 4.  True bifurcation- MB & SB are both significantly narrowed (>50% diameter stenosis). Non true bifurcations- all other lesions
  • 5. Strategy of stenting the MV with provisionalSB stenting is the current favored approach.Two stents strategy may be preferred, such asin the presence of a large SB that supplies asignificant area of myocardium especially whenside branch arises at a shallow angle.
  • 6. CLASSIFICATION OF BIFURCATION
  • 7. Medina Classification of Bifurcation Lesions Latib, A. et al. J Am Coll Cardiol Intv 2008;1:218-226Copyright ©2008 American College of Cardiology Foundation. Restrictions may apply.
  • 8. GENERAL APPROACH OFBIFURCATION LESION
  • 9. SECOND STENT IN SIDE BRANCHAFTER PROVISIONAL APPROACH T technique Modified T technique—SB stent first, when angle between MB & SB is near 90 degrees
  • 10. CRUSH TECHNIQUE
  • 11. T STENTING & SMALLPROTRUSION(TAP) T stenting & crush technique
  • 12. REVERSECRUSHTECHNIQUE Minimize any possible gap b/w MB & SB
  • 13. CULOTTE TECHNIQUE
  • 14. SKS TECHNIQUE
  • 15. THANK YOU

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