The successful treatment of coronary bifurcation lesions remains one of the challenges of interventional cardiology. The current consensus of the European Bifurcation Club based on published data advocates a provisional strategy, treating the main vessel (MV) with a single stent covering the side branch (SB), with bailout SB stenting as required. The success of this approach may be limited by failure to attain SB access after MV stenting but is preferred in most situations over routine SB plus MV stent techniques, which are associated with a significant increase in the rate of major adverse cardiac events. The AXXESS self-expanding biolimus-eluting stent has been developed as a solution to these challenges within the coronary circulation and maintains provisional MV stent approach but with added assurance of maintained SB access. It has a unique conical structure that is positioned spanning the carina, with scaffold extending into the carina of both the MV and SB. The purpose of this article is to describe the indication, implantation technique and outcome data supporting the use of the AXXESS stent in the treatment of coronary bifurcation lesions.
John Rawlins - Wessex Cardiothoracic Centre, University Hospital Southampton NHS Trust
Jehangir Din - Dorset Heart Centre, Royal Bournemouth Hospital, Castle Lane East, Bournemouth, UK
Suneel Talwar - Dorset Heart Centre, Royal Bournemouth Hospital, Castle Lane East, Bournemouth, UK
Peter O’Kane - Dorset Heart Centre, Royal Bournemouth Hospital, Castle Lane East, Bournemouth, UK