简介：Theoptimaldurationofdualantiplatelettherapy(DAPT)ofaspirinandaP2Y12receptorblockerafterstentingisstillbeingdebated.ThecurrentrecommendationsforDAPTdurationaresignificantlyfocusedonreducingstentthrombosis;alessfrequenteventwithlaterthanearliergenerationdrugelutingstents(DES).ApersistentoccurrenceoflateandverylatestentthrombosiswithfirstgenerationDESsupportedextendeduseofDAPTbeyondoneyear.However,recentstudieshavedemonstratedthatextendeddurationDAPTisassociatedwithincreasedbleeding;anindependentpredictorforpooroutcomes,includinglong-termmortality.Second-generationDESareassociatedwithlesslateandverylatestentthrombosis.SomerecentstudieshavesupportedashorterdurationofDAPTforsecondgenerationDES.However,thesestudieswereinadequatelypoweredtoassesssignificantdifferencesinstentthrombosis.Furthermore,extendeddurationDAPThasbeenassociatedwithareducedriskofthromboticeventsinnon-culpritvesselsinadditiontostentthrombosisinpatientswithacutecoronarysyndromes(ACS).ThehigherriskofbleedingassociatedwithextendedDAPTtherapyprovidesastrongrationaleforpersonalizedDAPTbasedonpatientriskfactors(e.g.ACSvs.non-ACS),typeofstents,andcost-benefitanalyses.

简介：ObjectivesToassesstheefficiencyandsafetyofdual-wireballoonangioplastysidebranchcombinedstentingthemainbranchinthetreatmentofcoronarybifurcationlesions.MethodsThisstudyincludedthirty-sixpatientswith41coronarybifurcationlesions.Selectivedual-wireballoonangioplastywasperformedinsidebranchand/orinmainbranch,andimplantationofstentswasperformedinmainbranchonly.Clinicaloutcomeandmajoradversecardiaceventswereobservedin-hospitalandfollow-up.ResultsSuccessrateofsidebranchdilatationbeforemainbranchstentingwas100%;mainbranchdirectstentingperformedin4cases;successmainbranchdilatationperformedintheother37cases;kissingtechniquewasperformedsuccessfullyin5cases,whichsidebranchwasjailedaftermainbranchstentingwithTIMIgrade0-2flow.NoQ-wavemyocardialinfarction,acuterevascularizationanddeathoccurredduringin-hospital.Clinicalfollow-upwasavailableinallpatients.NoQ-wavemyocardialinfarction,revascularizationanddeathoccurred,anginapectorisrecurredinthreepatients,releasedbystrengthendrugtreatment.ConclusionsDual-wireballoonangioplastysidebranchcombinedstentingthemainbranchissimple,safeandeffectiveforthetreatmentofcoronarybifurcationlesions.