Assessment of Coronary Bifurcation Stenting using Optical Coherence Tomography

Abstract

Coronary bifurcation lesions constitute about 15 20% of total percutaneous coronary interventions (PCI).1 Bifurcation PCI is technically challenging despite improvement in techniques and devices. Side-branch occlusion occurs in about 10% of bifurcation PCI cases.2 The long-term clinical outcome is also poor in these cases compared to non-bifurcation PCI.3,4 Conventional coronary angiography has several limitations in assessing this complex bifurcation site, both before and after PCI.1 Intravascular imaging has helped in better assessment of bifurcations lesions and improved procedural outcomes.5,6 Recently, with frequent use of high-resolution optical coherence tomography (OCT), these lesions can be better-assessed preand post-PCI.1,7 We evaluate the use of OCT for PCI optimization in bifurcation lesions, using provisional one-stent and elective two-stent strategies.