ABSTRACT
Bifurcation lesions A T-stenting approach with kissing balloon inflation is recommended. Even with the currently available larger-lumen 6 Fr catheters, it is not possible to advance two balloons 3.0-3.5 mm in diameter simultaneously, and catheters of at least 7 Fr will be needed unless the LAD and/or LCX are unusually small in diameter. Furthermore, the use of 7 Fr catheters enables the use of larger burrs for rotational atherectomy if needed. For more complex procedures that require the use of rotational atherectomy, burrs of more than 2.00 mm in diameter, or for directional atherectomy, a guiding catheter of 8 Fr or 9 Fr, will be needed. In the case of bifurcation lesions, support is the main issue, and ‘extra-backup’ shapes, Amplatz left, and, more recently, some of the specifically available longer-tip radial catheters are the best choice.
