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Dilation of Bifurcation Stenoses: Dr. Holmes replies

      My coauthors and I appreciate Dr. Brymer's letter. Dr. Brymer does point out that the Duostat is not a perfect device. The bend through the angled port may be difficult to negotiate. In our experience, however, we have been able to accomplish this maneuver. The technique of using a standard Tuohy-Borst adapter, as described by Dr. Brymer, can also be helpful as suggested. The increasing number of possible approaches helps to facilitate dilation of bifurcation stenoses and expands the number of patients in whom percutaneous transluminal coronary angioplasty is an attractive therapeutic option.

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      • Dilation of Bifurcation Stenoses
        Mayo Clinic ProceedingsVol. 64Issue 8
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          I read with interest the article by O'Keefe and associates, “A New Approach for Dilation of Bifurcation Stenoses: The Dual Probe Technique,” in the March 1989 issue of the Proceedings (pages 277 to 281). I have also used this technique in several patients; the “Probe” catheter (United States Catheter and Instrument Company [USCI], Billerica, Massachusetts) or the similar, recently introduced, “ACE” balloon-on-a-wire catheter (SciMed) has produced salutary results in bifurcation coronary artery lesions.
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