Predictors for Side Branch Failure During Provisional Strategy of Coronary Intervention for Bifurcation Lesions (from the Korean Bifurcation Registry)

Is side branch lesion length an independent predictor of acute side branch occlusion in provisional strategy? Analysis of 524 consecutive bifurcation lesions

“…Angiographic and IVUS studies also consistently reported that the plaque burden of the SB ostium was a risk factor of SB occlusion . Seo et al also reported that the distal segment of SB was not affected by MV stenting . As shown in our study, a longer SB lesion length was associated with a more complicated bifurcation anatomy, but it was still not a direct indicator of a heavier plaque burden at the branch ostium.…”

“…In the research of Hahn et al , the SB lesion length was an independent predictor of SB occlusion, and each 1‐mm increase in the lesion length was associated with a 1.03‐fold increased risk of SB occlusion. In the research of Seo et al , the SB lesion length was significantly different between the SB occlusion group and non‐SB occlusion group but was not an independent predictor of SB occlusion in multi‐variate regression analysis. However, in the present study, the SB lesion length was not significantly different between the SB occlusion group and non‐SB occlusion group.…”

Validation of the V‐RESOLVE (Visual Estimation for Risk prEdiction of Side Branch OccLusion in Coronary Bifurcation interVEntion) score system

“…A major concern for bifurcation intervention is to keep patency of a significant side branch (SB). While the aggressive strategy of stenting in SB for all bifurcations is inappropriate, the prevalent strategy of stenting in main vessel (MV) and provisionally stenting in SB leads to an SB occlusion rate of 6.1%–18% as previously reported , which suggests us that some bifurcation lesions are vulnerable to SB occlusion if treated with the provisional strategy. Identifying angiographic characteristics related with SB occlusion can help decision‐making in interventional strategy.…”

“…Previous studies have reported predictors of SB occlusion after MV stenting in coronary bifurcation lesions such as true bifurcation lesion, small SB reference, MV plaque thickness, and preprocedural stenosis of the SB ≥ 50% . However, the reported predictors were concluded from analyses by quantitative coronary angiography, optical coherence tomography (OCT), or intravascular ultrasound rather than directly visual estimation.…”

Usefulness of longitudinal reconstructed optical coherence tomography images for predicting the need for the reverse wire technique during coronary bifurcation interventions

“…The protection of an SB guidewire is sometimes necessary in a bifurcation lesion, especially in a true bifurcation, which has a high risk of SB occlusion during PCI . An SB guidewire is useful in bifurcation PCI for several reasons.…”