Key result
Percutaneous coronary intervention of left main bifurcation disease requires careful lesion classification, intravascular imaging guidance, and selection between provisional or two-stent strategies.
Why the study?
Left main bifurcation PCI is a challenging subset requiring evolving technical expertise, where procedural missteps can lead to stent thrombosis and critical in-stent restenosis.
This review provides a practical summary of contemporary techniques, imaging guidance, and procedural steps for optimizing outcomes in left main bifurcation percutaneous coronary intervention.
Emphasizes imaging and complexity-based technique selection in left main bifurcation PCI; leaves open need for randomized validation.
Left main bifurcation percutaneous coronary intervention is a challenging subset that requires expertise in techniques that are in constant modification. Imaging is important in lesion preparation and optimising outcomes. The interventionalist needs to be highly skilled in the different techniques, as missteps may lead to stent thrombosis and critical in-stent restenosis. Lesion classification between simple and complex identifies those who would best benefit from a two-stent technique. Current technical approaches and practice considerations are summarised in this manuscript.
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Rab et al. (2020) conducted a review in Left main bifurcation disease. Percutaneous coronary intervention (PCI) was evaluated. Percutaneous coronary intervention of left main bifurcation disease requires careful lesion classification, intravascular imaging guidance, and selection between provisional or two-stent strategies.
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