LAUSR

Stenting, initially with bare metal and subsequently with an antiproliferative drug coating, has undoubtedly been one of the major advances in the percutaneous treatment of obstructive coronary artery disease. All commercially available coronary stents have a cylindrical shape. With proper sizing, a single stent layer can fully “pave” the vessel wall in a straight arterial segment. However, in the case of a vessel bifurcation, a cylindrical stent shape cannot simply accommodate the lesion. As such, when two stents are needed, a multitude of techniques have been developed to treat lesions in the main and daughter vessels. One such technique, first described in 2007, is the “T and protrusion” (TAP) technique. If provisional stenting is attempted but is not successful, a second stent can be implanted in the side branch (SB) with a minimal stent length protruding into the main vessel (MV) creating a neocarina with minimal stent strut overlap. This technique has been widely accepted because of ease of use and some evidence of good outcomes. The assumption is that the closer one gets to “paving” the bifurcation with a single but continuous stent layer, the less likely