© 2004 by BMJ Publishing Group & British Cardiac Society
Images in cardiology
Intravascular ultrasound features of the "crush" technique for treatment of bifurcational coronary artery stenoses
adrian.banning@orh.nhs.uk
Keywords: Images in cardiology
| The first 150 words of the full text of this article appear below. |
A 60 year old man presented for elective treatment of a bifurcation lesion, involving both the mid left anterior descending artery (LAD) and the ostium of a large diagonal branch (D1) (panel B). Intravascular ultrasound examination confirmed the narrowing of D1, suggesting that stenting the LAD alone would result in significant side branch impairment (panels A and C).
Using an 8 French guide catheter, after preinflation, two paclitaxel drug eluting stents (Taxus, Boston Scientific) were advanced to the LAD and D1. The D1 stent was then inflated while the LAD stent was left in position. Then, after removing the D1 balloon and guidewire, the LAD stent was deployed, "crushing" the proximal part of the D1 stent behind it.
After rewiring D1, a "kissing balloon" postdilatation was undertaken.
The final IVUS run confirmed an excellent angiographic appearance (panel E), with the D1 ostium wide open (panel D), and visualised the "crushed"
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