Recent perspective on coronary bifurcation intervention: Statement of the "bifurcation club in KOKURA"

Yoshinobu Murasato, Yutaka Hikichi, Sunao Nakamura, Fumihiko Kajiya, Kiyotaka Iwasaki, Yoshihisa Kinoshita, Masahiro Yamawaki, Toshiro Shinke, Shnichiro Yamada, Takehiro Yamashita, Gim Hooi Choo, Chang Wook Nam, Young Hak Kim, Nigel Jepson, Miroslaw Ferenc

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

The treatment of coronary bifurcation lesion remains a challenging issue even in the drug-eluting stent era. Frequent restenosis and stent thrombosis have been recently shown to be related not only to geometrical gap or stent structural deformation but also to rheological disturbance. Low wall shear stress at the lateral side of the bifurcation is likely to cause atherosclerotic changes due to easy access of the macrophages that induce chemical mediators. The turbulent flow over stent metal may facilitate accumulation of platelets, which results in thrombosis. The jailed strut and excess metal overlap may increase these risks. Since dramatic changes of the coronary flow pattern at the bifurcation are closely related to the genesis of atherosclerosis, future bifurcation intervention technique should be considered to restore the original physiological state as well as the anatomical structure. This article summarizes the global consensus of the members of the Asian Bifurcation Club and European Bifurcation Club at the KOKURA meeting. It also provides a perspective of basic sciences relating to bifurcation anatomy, physiology, and pathology, in the search for a best strategy for bifurcation intervention.

Original languageEnglish
Pages (from-to)295-304
Number of pages10
JournalJournal of Interventional Cardiology
Volume23
Issue number4
DOIs
Publication statusPublished - 2010 Aug 1

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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