V and Y Stenting Techniques

Dr. Vedat Hekimsoy

Ankara Etlik City Hospital, Department of Cardiology, Ankara, Türkiye

ABSTRACT

Bifurcation lesions account for approximately 20% of cases addressed through percutaneous coronary inter- vention (PCI). The incidence of major adverse cardiac events after PCI is significantly greater for bifurcation lesions than for non-bifurcation lesions. The selection of a treatment strategy for bifurcations is influenced by the specific characteristics and complexity of the lesions. According to the latest guidelines from the Euro- pean Bifurcation Club, a one-stent approach is generally recommended for the majority of lesions, whereas a two-stent strategy may be advisable for more intricate lesions with a prominent side branch that supplies a considerable myocardial area. Multiple methods utilizing one or two stents have been established to enhance the management of coronary bifurcation lesions. Several techniques involving two stents exist, each varying in complexity and specific indications: T-stenting, T and protrusion (TAP), classic crush, mini crush, double kissing (DK) crush, culotte stenting, V stenting, Y stenting. In this section, an overview of the V stenting and Y stenting techniques is provided, highlighting their individual benefits and drawbacks. The V stenting method is deemed appropriate for treating bifurcation lesions, provided that the segment of the vessel just before the bifurcation is unaffected by disease and there is no requirement for placing a stent more proximally. The Y-stenting method holds significant historical importance as it was the first bifurcation stenting technique documented in the literature. The Y stenting method offers a viable solution for managing complex bifurca- tions that require continued wire access to both the main branch and the side branch.

Keywords: Coronary bifurcation lesions; Provisional stent strategy; Two-stent strategy; V stenting; Y stenting

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