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Prognostic implications of ischemia with nonobstructive coronary arteries (INOCA): Understanding risks for improving treatment Fractional Flow Reserve–Guided PCI for Stable Coronary Artery Disease Meta-Analysis of Death and Myocardial Infarction in the DEFINE-FLAIR and iFR-SWEDEHEART Trials Left main coronary artery compression in pulmonary hypertension The EBC TWO Study (European Bifurcation Coronary TWO): A Randomized Comparison of Provisional T-Stenting Versus a Systematic 2 Stent Culotte Strategy in Large Caliber True Bifurcations OCT compared with IVUS in a coronary lesion assessment: the OPUS-CLASS study Updated clinical classification of pulmonary hypertension Retrospective Comparison of Long-Term Clinical Outcomes Between Percutaneous Coronary Intervention and Medical Therapy in Stable Coronary Artery Disease With Gray Zone Fractional Flow Reserve - COMFORTABLE Retrospective Study Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation Long-term outcomes of routine versus provisional T-stenting for de novo coronary bifurcation lesions: five-year results of the Bifurcations Bad Krozingen I study

Review Article2018 Feb 2;13(15):e1804-e1811.

JOURNAL:EuroIntervention. Article Link

Step-by-step manual for planning and performing bifurcation PCI: a resource-tailored approach

Milasinovic D, Wijns W, Ntsekhe M et al. Keywords: drug-eluting stent; bifurcation; bare metal stent

ABSTRACT


As bifurcation PCI can often be resource-demanding due to the use of multiple guidewires, balloons and stents, different technical options are sometimes being explored, in different local settings, to meet the need of optimally treating a patient with a bifurcation lesion, while being confronted with limited material resources. Therefore, it seems important to keep a proper balance between what is recognised as the contemporary state of the art, and what is known to be potentially harmful and to be discouraged. Ultimately, the resource-tailored approach to bifurcation PCI may be characterised by the notion of minimum technical requirements for each step of a successful procedure. Hence, this paper describes the logical sequence of steps when performing bifurcation PCI with provisional SB stenting, starting with basic anatomy assessment and ending with the optimisation of MB stenting and the evaluation of the potential need to stent the SB, suggesting, for each step, the minimum technical requirement for a successful intervention.