IMR Press / RCM / Volume 24 / Issue 11 / DOI: 10.31083/j.rcm2411323
Open Access Review
Review of Techniques for Protecting Side Branch from Occlusion during Provisional Stenting in Coronary Bifurcation Lesions
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1 Department of Cardiology, Tangdu Hospital, Air Force Medical University, 710038 Xi'an, Shaanxi, China
2 Department of Endocrinology, Tangdu Hospital, Air Force Medical University, 710038 Xi'an, Shaanxi, China
*Correspondence: 18220870848@163.com (Aili Yang); wg_guo@fmmu.edu.cn (Wangang Guo)
These authors contributed equally.
Rev. Cardiovasc. Med. 2023, 24(11), 323; https://doi.org/10.31083/j.rcm2411323
Submitted: 15 December 2022 | Revised: 13 February 2023 | Accepted: 17 February 2023 | Published: 23 November 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

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.

Keywords
coronary bifurcation lesion
crossover stenting
MACE
provisional stenting
side branch occlusion
Funding
2021LCYJ044/Tangdu Innovative Development Project
Figures
Fig. 1.
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