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The objective was to estimate the risk and predictors of intraoperative transition from a single-stent technique of correction of bifurcation lesions of the coronary arteries to a double-stent technique.METHODS AND MATHERIALS. The study included 49 patients (35 men – 71.4 % and 14 women – 28.6 %) with acute coronary syndrome, whose coronary angiography revealed non-stem bifurcation lesions of the coronary arteries. The patients were operated with single- (Provisional) and double- (Culotte and TAR) stent techniques. Three patients had two bifurcation lesions at once. Thus, 52 bifurcations were included in the study. The average age of patients was 62±8 years. The lateral branch was affected in 34.6 % of cases. A blood clot in the bifurcation area was visualized in 15.4 % of cases. The study is a prospective analytical one. Statistical data processing was carried out using the chi-square test. The statistically significant value was considered p

The aim. To study the long-term results of stenting in patients with coronary artery disease with hemodynamically significant left main coronary artery (LMCA) stenoses. Materials and methods. The study included 67 patients (56 men, 11 women) with a mean age of 63 ± 2.1 years. Results. Among the 67 patients included in the study, 29 patients (43.3%) underwent percutaneous coronary inter-vention using a single-stent technique. These were patients with ostial LMCA lesions, lesions of the middle third of the LMCA and some patients with Medina 1.1.0; 1.0.1; 1.0.0; 0.1.0; 0.0.1 lesions of the distal part of the LMCA. The median follow-up was 2 years. Using a questionnaire, we managed to establish contact with 25 patients (86.2%). Among these, 1 patient (3.4%) died of non-cardiac causes and 7 patients (24.1%) had a recurrence of angina within 2 years. The causes of angina recurrence in 2 cases (6.9%) were restenosis in the stent with transition to the mouth of the side branch, which required repeated stenting of the LMCA with transition to the left circumflex artery. In 5 patients (17.2%), angina recur-rence was associated with progression of coronary atherosclerosis of another localization. Among 67 patients with LMCA stenting, the two-stent technique was used in 38 patients (56.7%). These were pa-tients with Medina 1.1.0; 1.0.1; 1.0.0; 0.1.0; 0.0.1 lesions of the distal part of the LMCA. The median follow-up was 2 years. Using a questionnaire, we managed to contact 35 patients (92.1%). Among these, 4 patients (10.5%) died, but only one of them due to cardiac causes (2.6%), and 3 patients (7.9%) had recurrent angina within 2 years, two of whom underwent stenting by the T and protrusion (TAP) technique and one by culotte. The first two patients underwent angioplasty of restenosis in stents using balloons with a therapeutic coating. In the last patient, stent recoil in the left circumflex artery mouth was observed due to severe calcification, so this patient underwent re-implantation of the stent system in the recoil zone. Conclusions. The problem of choosing a method of revascularization for patients with hemodynamically significant LMCA lesions remains controversial to this day, despite the wide range of evidence. Doctors should jointly decide on the choice of treatment methodology solely in the interests of the patient, taking into account all the factors that may affect the patient’s quality of life in the long term.

Current evidence and guidelines support the use of the single-stent technique as the default treatment strategy for the treatment of coronary bifurcations. For the single-stent technique, routine final kissing balloon inflation is not recommended, unless side branch ostial stenosis is assumed to be functionally significant. The double-stent technique is still a viable option for bifurcations with large and severely diseased side branches. Due to the unique features of bifurcation anatomy and bifurcation stenting techniques, all deployed stents should be optimized by postdilation, kissing balloon inflation and/or the proximal optimization technique, regardless of the stenting technique used. Intravascular ultrasound can guide preimplantation decision-making and postimplantation optimization by providing information on reference diameter, plaque burden and distribution, and stent underexpansion and malapposition. [ABSTRACT FROM AUTHOR]