Carina modification T stenting, a new bifurcation stenting technique: clinical and angiographic data from the first 156 consecutive patients

Catheter Cardiovasc Interv. 2009 Nov 1;74(5):683-90. doi: 10.1002/ccd.22086.


Objectives: To describe a new technique, the Carina modification T stenting (CMT), which will provide an easily reproducible strategy for tackling bifurcation lesions in different patient and anatomic subsets.

Background: The optimal treatment of coronary bifurcation lesions remains problematic. The question of using one stent in the main vessel (MV) with PTCA of the side-branch (SB) versus stenting both arms (MV and SB) is debated. More importantly, the technique of choice once a two-stent approach is chosen is suboptimal because of technical difficulties encountered. This includes lack of osteal side branch coverage, difficulties with access to the side-branch for a mandatory final balloon kissing, and the presence of thrombogenic layers of crushed stents.

Methods: We describe here the CMT procedure for bifurcational coronary stenosis, and present the angiographic and clinical outcomes in 156 consecutive patients who underwent bifurcation PCI using CMT in our center.

Results: Short and medium term results show a 99% procedural success rate with low major adverse coronary events (MACE), including a low rate of clinical restenosis. MACE free survival rate at 48 months follow-up was 88%.

Conclusions: The new CMT method of bifurcational PCI demonstrated advantages in terms of technical feasibility, ostial side branch coverage, and favorable patient outcome. Further evaluation with larger studies and long term follow-up is warranted.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary* / adverse effects
  • Angioplasty, Balloon, Coronary* / instrumentation
  • Angioplasty, Balloon, Coronary* / methods
  • Angioplasty, Balloon, Coronary* / mortality
  • Coronary Angiography*
  • Coronary Restenosis / etiology
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / drug therapy*
  • Coronary Stenosis / mortality
  • Feasibility Studies
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology
  • Prosthesis Design
  • Severity of Illness Index
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Interventional