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HOW I TREAT TYPE 001 LAD/DIAG CORONARY LESIONS

HOW I TREAT TYPE 001 LAD/DIAG CORONARY LESIONS. Dr Philippe BRUNEL Unité de Soins et de Cardiologie Interventionelle Nouvelles Cliniques Nantaises NANTES FRANCE. TYPE 001 LAD/DIAG CORONARY LESIONS. Type 4b lesions (branch ostial lesions) are very challenging because

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HOW I TREAT TYPE 001 LAD/DIAG CORONARY LESIONS

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  1. HOW I TREAT TYPE 001 LAD/DIAG CORONARY LESIONS Dr Philippe BRUNEL Unité de Soins et de Cardiologie Interventionelle Nouvelles Cliniques Nantaises NANTES FRANCE

  2. TYPE 001 LAD/DIAG CORONARY LESIONS • Type 4b lesions (branch ostial lesions) are very challenging • because • 1) perfect ostial stent positioning is difficult; • 2) there • is a high risk of snow-plough effect (especially in Y shape • lesions) in the main branch leading to balloon angioplasty and • sometimes stenting of a previously healthy main branch • For this reason, other strategies such as • debulking or cutting balloon may be considered. Medical • treatment or even CABG surgery should also be discussed.

  3. TYPE 001 LAD/DIAG CORONARY LESIONS

  4. TULIPE STUDY TREATED LESIONS Provisional T-stenting and kissing balloon in the treatment of coronary bifurcation lesions: Results of the French multicenter "TULIPE" study. Catheter Cardiovasc Interv. 2006 Jul;68(1):67-73 Brunel P, Lefevre T, Darremont O, Louvard Y. 14 French centers 186 patients : Zeta/Penta Stent on the main 1 stent : 66% Final kissing : 96% TLR : 15.88%

  5. Tulipe study : treated lesions

  6. TYPE 001 LAD/DIAG CORONARY LESIONS

  7. BIF TYPE • BIF 346 • 111 162 47% • 110 71 20.5% • 100 10 3% • 011 8 2.3% • 010 53 15% • 001 42 12% • 42 type 001

  8. BIF TYPE • BIF 346 • 111 162 47% • 110 71 20.5% • 100 10 3% • 011 8 2.3% • 010 53 15% • 001 42 12% • 42 type 001

  9. TYPE C TREATMENT FOR TYPE 001 BIF • 2005 to 09/2006 • 42 type 001 (except Ostial LAD or CX)/4531treated sites, 2393 patients • 23 type C stents, success 95%, (1 failure to recross the distal part of the stent for kissing)

  10. Conclusion Type 001 Bifurcation treatment is not a frequent situation but technically more challenging (diameter differences) Good results of type B treatment with BMS and DES Application of this technique was successfull Compliance of the Taxus Liberté stent delivery system Good acute results

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