JACC Cardiovasc Interv 2008 1:218-26.įor example, a lesion involving the proximal and distal MB without any SB involvement is classified as Medina “1,1,0”. Reproduced with permission from Latib et al. Medina Classification for Coronary Bifurcation Lesions. The Medina classification assesses plaque burden based on the presence (“1”) or absence (“0”) of stenosis in the proximal MB, distal MB, and SB (Figure 1). The simplest and most widely used is the Medina classification. Numerous classification schemes have been proposed to characterize coronary bifurcation lesions. The European Bifurcation Club defines a bifurcation lesion as a significant stenosis (i.e., >50%) in a coronary artery adjacent to and/or involving the origin of an SB that is clinically significant. The carina is the inflection point at which the proximal MB bifurcates into the distal MB and SB. Characterizing bifurcation lesions involves assessing the lesion morphology in three important anatomic segments: (1) proximal main branch (MB) (2) distal MB and (3) side branch (SB). 2011 24:426–436.A coronary bifurcation lesion occurs at or near a division of a major coronary artery. Long-term clinical and angiographic results of Sirolimus-Eluting Stent in Complex Coronary Chronic Total Occlusion Revascularization: the SECTOR registry. Galassi AR, Tomasello SD, Costanzo L, Campisano MB, Barrano G, Tamburino C. Long-term clinical and angiographic outcomes of the mini-STAR technique as a bailout strategy for percutaneous coronary intervention of chronic total occlusion. Galassi AR, Boukhris M, Tomasello SD, Marzà F, Azzarelli S, Giubilato S, Khamis H. Impact of intra-aortic balloon pumping on hypotension and outcomes in acute right ventricular infarction. Transient impairment of vasomotion function after successful chronic total occlusion recanalization. Galassi AR, Tomasello SD, Crea F, Costanzo L, Campisano MB, Marzá F, Tamburino C. The innovation of composite core dual coil coronary guide-wire technology: a didactic coronary chronic total occlusion revascularization case report. Tomasello SD, Giudice P, Attisano T, Boukhris M, Galassi AR. In both cases, the GuideLiner catheter provided a good back-up insuring the success of PCI and drug-eluting stents implantation, with a good in-hospital outcome.Ĭardiac catheters Equipment and supplies Percutaneous coronary intervention. The second case was an elective PCI in a 76-year-old man admitted for stable angina (Canadian Cardiovascular Society class III), related to focal intra-stent restenosis of a saphenous venous graft to the left anterior descending.
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The first case was a primary percutaneous coronary intervention (PCI) in a 71-year-old diabetic man admitted for inferior ST-elevation myocardial infarction, related to tight proximal stenosis in a dominant tortuous and calcified left circumflex.
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We report two didactic cases showing the usefulness of the GuideLiner device in everyday catheterization laboratory practice. As a "mother and child" system, the GuideLiner catheter (Vascular Solutions Inc., Minneapolis, MN, USA) provides an extension to the guide catheter with better coaxial alignment and stability. Regardless of the clinical setting, a good back-up represents one of the most important conditions to ensure guide wire and balloon advancement and stent delivery.