Sean Tan1, John Ramzy1, Sonya Burgess2,3, Sarah Zaman4,5. 1. MonashHeart, Monash Health, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia. 2. The University of New South Wales, Sydney, NSW, Australia. 3. Department of Cardiology, Nepean Hospital, Sydney, NSW, Australia. 4. MonashHeart, Monash Health, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia. sarah.zaman@monash.edu. 5. Monash Cardiovascular Research Centre, Monash University, Melbourne, Australia. sarah.zaman@monash.edu.
Abstract
PURPOSE OF REVIEW: This paper provides a synopsis of the best evidence to guide bifurcation percutaneous coronary intervention (PCI), with a focus on recent studies. This is with the aim of guiding the interventional cardiologist in choosing the best, evidence-based technique, to treat commonly encountered coronary bifurcations. RECENT FINDINGS: Current evidence supports the use of provisional stenting for most anatomically suitable bifurcation lesions. Newer techniques for side branch protection in provisional stenting have been developed. When a two-stent strategy is required, use of a double-kissing crush technique is favoured, particularly in left main bifurcations. For bifurcation PCI, as in all complex procedures, intravascular imaging plays a key adjunctive role in improving procedural success. PCI for coronary bifurcation lesions is an ever-growing field with significant advancements in techniques and technology.
PURPOSE OF REVIEW: This paper provides a synopsis of the best evidence to guide bifurcation percutaneous coronary intervention (PCI), with a focus on recent studies. This is with the aim of guiding the interventional cardiologist in choosing the best, evidence-based technique, to treat commonly encountered coronary bifurcations. RECENT FINDINGS: Current evidence supports the use of provisional stenting for most anatomically suitable bifurcation lesions. Newer techniques for side branch protection in provisional stenting have been developed. When a two-stent strategy is required, use of a double-kissing crush technique is favoured, particularly in left main bifurcations. For bifurcation PCI, as in all complex procedures, intravascular imaging plays a key adjunctive role in improving procedural success. PCI for coronary bifurcation lesions is an ever-growing field with significant advancements in techniques and technology.