冠状动脉分叉病变(CBL)占所有经皮冠状动脉介入治疗的15%-20%。这些病变的复杂性是导致手术效果较差的原因,早期和晚期结果。这个复杂的病变子集在介入心脏界受到了极大的关注,并且已经开发了多种支架技术。其中,临时支架技术通常是默认策略;然而,在复杂CBL的某些子集中,选择性双支架(EDS)技术是首选。双吻挤压技术可能是首选的EDS技术,因为它在比较试验中具有有效性和安全性;然而,这种技术包括许多步骤,需要训练。最近在EDS技术中添加了许多新方法,以提供更好的支架支架并减少早期和晚期的不良后果。血管内成像对于确定介入策略和介入后结果是必要的。这篇综述讨论了基本概念,当代经皮介入技术方法,新方法,和有争议的CBL治疗问题。
Coronary bifurcation lesions (CBLs) account for 15%-20% of all percutaneous coronary interventions. The complex nature of these lesions is responsible for poorer procedural, early and late outcomes. This complex lesion subset has received great attention in the interventional cardiac community, and multiple stenting techniques have been developed. Of these, the provisional stenting technique is most often the default strategy; however, the elective double stenting (EDS) technique is preferred in certain subsets of complex CBLs. The double kissing crush technique may be the preferred EDS technique because of its efficacy and safety in comparative trials; however, this technique consists of many steps and requires training. Many new methods have recently been added to the EDS techniques to provide better stent scaffolding and to reduce early and late adverse outcomes. Intravascular imaging is necessary to determine the interventional strategy and postinterventional results. This review discusses the basic concepts, contemporary percutaneous interventional technical approaches, new methods, and controversial treatment issues of CBLs.