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Balloon Alignment T-Stenting for Bifurcation Coronary Artery Disease Using the Sirolimus-Eluting Stent
David G. Rizik, MD, Denise A. Dowler, MSN, NP, Bernard J. Villegas, MD
August 2005
Case Presentation. A 65-year-old gentleman, who works as a professional football referee, presented with progressive symptoms of angina. His job officiating games necessitated significant physical activity and endurance. He presented 10 days prior to the opening game of the season and was referred for subsequent noninvasive testing, which demonstrated a large area of ischemia in the anterior and anterolateral distribution.
Cardiac catheterization demonstrated high-grade bifurcation disease involving the left anterior descending artery (LAD), as well as the major diagonal branch. We performed bifurcation percutaneous coronary intervention (P.C.I.) with drug-eluting stents (DES) utilizing a novel “balloon alignment T-stenting” technique (described below). The patient returned to work shortly thereafter and completed the current season.
Upon completion of the current football season in which he continued to be actively involved as a referee, we performed a 9-month anniversary angiogram which showed wide patency of both the LAD and the diagonal branch. No evidence of in-stent restenosis in either vessel was present.
Our center has now performed 30 consecutive bifurcation PCIs exclusively utilizing drug-eluting stents implanted through this technique. We are in the process of collecting follow-up data including quantitative coronary angiography. The balloon alignment T-stenting technique is described below in detail. The full follow-up analysis of our study is the subject of a future manuscript which is currently in preparation.
Email: davidrizik@aol.com
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