Cullotte is a trouser worn by 18th century French aristocrats.Now,in 21st century French interventional cardiologists found a striking similarity of cullotte with two stent strategy in bifurcation lesion .
Though this technique is in vogue for more than a decade , it has not been popular due to perceived complexity .
It is making a come back in recent years , as we begin to negotiate bifurcation lesions with better expertise and hardware.
7 steps in Culotte technique (From NORDIC study )
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Wiring both main and side branch .
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Pre-dilatation of main branch and/or side branch,( Optional)
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Stenting of main branch
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Rewiring side branch through main branch stent strut,
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Stenting of side branch through main branch stent,(Now main branch is jailed by side branch stent
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Recross main branch through struts of SB.
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Procedure completed with final kissing balloon dilatation
Reference
http://heart.bmj.com/content/90/6/713.full.pdf+html
Dr.S.Venkatesan MD 