《国际循环》：There are a number of two-stent approaches for treating bifurcation lesions now, including T-stenting, V-stenting, crush and its variations, and the Culotte etc. My question is how to perform those techniques to suitable patients.
用于分叉病变治疗的双支架方法有很多，如T-stenting、V-stenting、Crush、Culotte技术等，对于这些技术应如何应用？

P.S. Sanzgiri 教授： V stent. V stent for the large vessels, and provisional for ones whose side branch is too small. For left main (coronary artery), I always do provisional or V stent. If neither can be done, I put the patient for open heart surgery. OK?
V支架。V支架主要用于大血管，而当病变血管的侧枝太小时，我们使用临时支架。对于左主干病变，我一般习惯放置临时支架或V支架，如果两种支架都无法放置，我一般建议病人接受开胸的心脏手术。这样说你可以理解吗？

《国际循环》：Ah, OK
恩，可以。

P.S. Sanzgiri 教授：The kissing balloon is the final step. You always have to do kissing balloon.
Indication has only one standard, the best technique for the patient and for us. Thus I just put one stent in the main vessel, it’s provisional technique, one stent in the main vessel. Then I build up the kissing balloon, and if you have a good flow, and no critical lesion in the ostium of the branch, it’s only provisional. If it’s a very, very difficult case, and the patient begins with pain, and the side branch is clinical important, I do two stents. If you have a very big vessel, I put a V stent, but with very very few patients. Almost every time I put only one stent in the main Vessel, even for a left main and LAD. I do kissing balloon, the reason is during kissing balloon at the end of the procedure, the final kissing balloon reduces the restenosis rate. OK?
不管哪种支架放置方法，最后都需要双球囊对吻技术（kissing balloon）。我们经常需要用到双球囊对吻技术。技术的适应症只有一个标准，就是对病人对医生来说是达到目的的最佳技术。这样我只需要在主要的病变血管上放置一个支架，放置一个临时支架就可以了，关键血管一个支架解决问题。然后我再利用双球囊对吻技术扩张支架，如果如果远段血管的供血好，分支开口处没有严重病变，那么一个支架就足够了。如果病人的病情非常复杂，病人以疼痛起病且侧支循环对病人而言有重要的临床意义，那么我可能会考虑放置两个支架。如果病人的血管非常非常粗，我就放置V支架，但这种情况很少见。一般情况下我都在主要血管放置一个支架就够了，即使是左主干和前降支血管。我会选择双球囊对吻技术，因为在介入操作的最后进行双球囊对吻可以减少支架的再狭窄率。

《国际循环》： OK, thanks.
谢谢。