Percutaneous Coronary Intervention for Bifurcation Lesions: A State-of-the-Art Review of Techniques and Dedicated Devices

Abstract

Percutaneous coronary intervention (PCI) has become an integral step in the management of patients with ischaemic heart disease. Bifurcation lesions are commonly encountered in PCI and are regarded as the most technically challenging lesions to treat. The literature is saturated with studies that explore the best way to treat these lesions, with a variety of techniques introduced to enable stenting of both vessels. However, the optimal method is still undetermined. In this state-of-the-art review, we discuss the various strategies that are currently regarded as ideal, particularly those which involve one or two-stent techniques. Moreover, dedicated bifurcation devices have been developed to facilitate bifurcation stenting and improve outcomes. The role of these devices in this context is also uncertain, therefore we will discuss the current evidence for their use. Finally, a road map on the ‘tips and tricks’ to successfully perform bifurcation PCI is mentioned, which will aid any interventionist performing this procedure in an optimal manner.