Coronary bifurcation lesions remain one of the most challenging lesions for
cardiology interventionists. The provisional stenting strategy has been regarded
as the first option for most of these lesions. However, the main complication of
this technique is side branch (SB) occlusion, which could lead to a
peri-procedural myocardial infarction or even death. Various studies have focused
on addressing this issue, but there are no definitive guidelines in the
literature to treat these lesions. There isn’t enough clinical evidence from
randomized controlled trial or two-arm cohort studies to illustrate which
techniques provide the best outcomes. In this review, we summarize the
mechanisms, independent predictors and predictive models of SB occlusion, and
review seventeen techniques involving SB protection and occlusion rescue. Every
technique was evaluated according to related bench tests, clinical studies and
our own clinical experiences. The aim of this review is to provide
interventionists with new insights for the treatment of coronary bifurcation
lesions.