title: Percutaneous Coronary Intervention for Bifurcation: How Can We Outperform the Provisional Strategy?
abstract: In the era of drug-eluting stents, the provisional stenting strategy has been established as the default strategy in percutaneous coronary intervention for bifurcation lesions. However, emerging evidence shows that, in selected situations, the complex strategy of stenting both vessels regardless could reduce side-branch restenosis without penalty. In particular, the double kissing crush technique has been proven to outperform the provisional strategy and other complex strategies in randomized trials. In this review, we present the evidence comparing the 2 strategies and individual stenting techniques and discuss the roles of other optimization techniques such as final kissing balloon inflation, proximal optimization technique, intravascular ultrasonography, and optical coherence tomography. Finally, we suggest a practical approach for choosing the optimal strategy for intervention with coronary bifurcation lesions.
authors.affiliation: Cardiac Medical Unit, Grantham Hospital, Hong Kong.
authors.forename: Andrew Kei-Yan
authors.initials: AK
authors.lastname: Ng
authors.affiliation: Cardiac Medical Unit, Grantham Hospital, Hong Kong.
authors.forename: Man-Hong
authors.initials: MH
authors.lastname: Jim
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D006801:Humans; D018579:Patient Selection; D011237:Predictive Value of Tests; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: Coronary artery disease; Coronary bifurcation lesion; Percutaneous coronary intervention