Functional Side-Branch Stenosis After Cross-Over Stenting: It has Always Been a Matter of Plaque

摘要

Despite advances in catheter-based technology, coronary artery bifurcations continue to defy operators. In fact for decades, we have been fascinated by the diverse morphology of coronary bifurcations (i.e., degree of angulations, various branch sizes, and patterns of plaque distribution) along with the erratic changes in luminal size exhibited after cross-over stenting. Currently, a large body of evidence supports main branch (MB) stenting with provisional side branch (SB) stenting as the primary strategy for the vast majority of bifurcations [1]. With this strategy, poststenting SB narrowing occurs often. Recently, a serial intravascular ultrasound (IVUS) imaging study elucidated the mechanism responsible for SB narrowing following cross-over stenting [2].