TREATMENT STRATEGIES FOR BIFURCATION LESIONS

Percutaneous transluminal angioplasty of coronary artery bifurcations represents a still evolving field of interventional cardiology. The di latation of stenoses located at the site of coronary bifurcations has been limited by the risk of side branch occlusion with subsequent myoc ardial infarction and high rates of late restenosis. The initial succe ss rates of conventional balloon dilatation were improved by the intro duction of side branch protection using two guidewires as well as the ''kissing balloon'' technique. The potential advantage of atherectomy techniques, however, was associated with a high incidence of acute com plications. While bifurcation stenting promises to allow optimal geome tric reconstruction of bifurcation lesions using multiple or single co mponent bifurcation stents, late intimal hyperplasia remains a potenti al limitation of this interventional approach.