Webinar 12 | DCBs in Coronary Bifurcation Lesions-Case: DCB Treatment for Calcified Bifurcation Lesions, Dr. Bruno Scheller

Case: DCB Treatment for Calcified Bifurcation Lesions, Dr. Bruno Scheller

Video Transcription

Video Summary

The discussion centers on treating coronary bifurcation lesions, emphasizing lesion preparation and the use of drug-coated balloons (DCB) versus stenting. Challenges arise from variable vessel diameters, angles, and calcifications, which complicate stent use. Evidence suggests a two-stent strategy often leads to poorer long-term outcomes compared to a provisional one-stent approach. The speaker advocates for a "leaving nothing behind" method using sequential DCBs, starting with lesion preparation using non-compliant and specialty balloons, escalating to intravascular lithotripsy or rotational atherectomy in severe calcification cases. Imaging guides lesion preparation but not the decision to use stents or DCBs. Dissections post-DCB are closely monitored; only flow-limiting dissections prompt stenting. Dual antiplatelet therapy (DAPT) durations depend on stent implantation and clinical stability, often four weeks without stents. The approach simplifies procedure complexity and may reduce restenosis, with ongoing trials aiming to provide further evidence for these strategies.

Keywords

coronary bifurcation lesions

drug-coated balloons

two-stent strategy

lesion preparation

dual antiplatelet therapy