axxess bifurcation dedicated self-expandable drug eluting stent. step by step tutorial. part 1...
TRANSCRIPT
![Page 1: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/1.jpg)
![Page 2: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/2.jpg)
Male BD 29/7/1932
Hypertension, smoking
1999 STEMI anterior > DES LAD
2003 PM VVI
2014 Effort angina
Positive exercise test – V3-V6
29/8/2014 DES on PD (RCA)
Residual stenosis LAD/D1
![Page 3: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/3.jpg)
Femoral
LAD/D1 stenosis
Medina 1.0.1
![Page 4: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/4.jpg)
Femoral
LAD/D1 stenosis
Medina 1.0.1
![Page 5: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/5.jpg)
Femoral
LAD/D1 stenosis
Medina 1.0.1
![Page 6: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/6.jpg)
Femoral
LAD/D1 stenosis
Medina 1.0.1
![Page 7: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/7.jpg)
Femoral
LAD/D1 stenosis
Medina 1.0.1
![Page 8: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/8.jpg)
Femoral
LAD/D1 stenosis
Medina 1.0.1
![Page 9: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/9.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• NC Empira 2,5x12
POBA LAD
![Page 10: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/10.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• NC Empira 2,5x12
POBA LAD
![Page 11: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/11.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• PostNC Empira 2,5x12
Result LAD
![Page 12: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/12.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• PostNC Empira 2,5x12
Result LAD
![Page 13: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/13.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Sprinter 2,0 x 102
POBA D1
![Page 14: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/14.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• NC Empira2,5 x 15
POBA D1
![Page 15: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/15.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• NC Empira2,5 x 15
POBA D1
![Page 16: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/16.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• IVA satisfying
• D1
• Not satissfying
Result post POBA
![Page 17: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/17.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• IVA satisfying
• D1
• Not satissfying
Result post POBA
![Page 18: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/18.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• IVA satisfying
• D1
• Not satissfying
Result post POBA
![Page 19: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/19.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• IVA satisfying
• D1
• Not satissfying
Result post POBA
![Page 20: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/20.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• NC Empira2,5 x 15
2nd POBA D1
![Page 21: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/21.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• NC Empira2,5 x 15
2nd POBA D1
![Page 22: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/22.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• NC Empira2,5 x 15
3rd POBA LAD
![Page 23: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/23.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• NC Empira2,5 x 15
3rd POBA LAD
![Page 24: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/24.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Satisfying
Result post POBA
![Page 25: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/25.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Satisfying
Result post POBA
![Page 26: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/26.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Inside the GC
Axxess 3,0x11
![Page 27: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/27.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Inside the GC
Axxess 3,0x11
![Page 28: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/28.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• After the bifurcation
Axxess
![Page 29: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/29.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• After the bifurcation
Axxess
![Page 30: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/30.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Correct position
• Start opening
Axxess
![Page 31: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/31.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Correct position
• Start opening
Axxess
![Page 32: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/32.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Two markers in D1
• One marker in LAD
Axxess
![Page 33: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/33.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Two markers in D1
• One marker in LAD
Axxess
![Page 34: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/34.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Two markers in D1
• One marker in LAD
Axxess
![Page 35: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/35.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Two markers in D1
• One marker in LAD
Axxess
![Page 36: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/36.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Point of no return
Axxess
![Page 37: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/37.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Point of no return
Axxess
![Page 38: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/38.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Complete opening
Axxess
![Page 39: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/39.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Removing the whole system
Axxess
![Page 40: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/40.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Result
Axxess
![Page 41: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/41.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Result
Axxess
![Page 42: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/42.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Rewiring LAD
Axxess
![Page 43: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/43.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Rewiring LAD
Axxess
![Page 44: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/44.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Biomatrix 2,25 x 14
DES D1
![Page 45: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/45.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Biomatrix 2,25 x 14
DES D1
![Page 46: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/46.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Biomatrix 2,25 x 14
DES D1
![Page 47: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/47.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Biomatrix 2,25 x 14
DES D1
![Page 48: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/48.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Kissing LAD/D1
Finalizing
![Page 49: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/49.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
• Kissing LAD/D1
Finalizing
![Page 50: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/50.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
Final result
![Page 51: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/51.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
Final result
![Page 52: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/52.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
Final result
![Page 53: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/53.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
Final result
![Page 54: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/54.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
Final result
![Page 55: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/55.jpg)
Sheathless 7,5F PB
Sion Blu LAD
Luge D1
Final result
![Page 56: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/56.jpg)
•Two orthogonal, projection. Enough contrast. Higher frame rate
Good visualization of the bifurcation
•At least 7F GC. Sheathless 7,5F is good for radial. Choose GC permitting sufficient support.
Guiding catheter
•Use sufficiently supportive wires
Wires
•Prepare both branches gradually incrementing the balloon diameter. Use non compliant balloon if needed. Prepare the lesion – stent like result. Control the preparation in two projection
Lesion preparation
![Page 57: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/57.jpg)
•Use the wire of the branch less angulated respect the parent vessel
Wire to chose for Axxess placement
•When the distal stent markers are exactly at the carina start slowly, very slowly to open the stent
Initial opening Axxess
•Once the three distal markers start to separate at the carina site, push gently the system to see their further separation and to feel resistance
Engaging the carina
•When seeing one distal stent marker in one branch and rest distal markers in the other branch.
•Confirm with another projection the same separation of the markers
Confirming the correct position
![Page 58: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/58.jpg)
•Once confirmed the correct position in two projection
Final opening of Axxess
•While opening the stent push the whole system to see how the distal part of the stent engages the branches
•Use contrast to control the position
Technique of opening Axxess
•Once delivered the stent control it in two orthogonal projection
•Evaluate well, even with zoom the proximal and the distal part of the stent
Finalising the procedure
•Use two appropriate to the branches balloons in kissing technique
• If need place further stents to the side, main or parent vessel
Post-dilatation
![Page 59: AXXESS bifurcation dedicated self-expandable drug eluting stent. Step by step tutorial. Part 1 Implantation on LAD/D1 bifurcation](https://reader035.vdocument.in/reader035/viewer/2022062419/55ac00c31a28ab7c718b46c6/html5/thumbnails/59.jpg)