17 May 2023
Bifurcation with provisional stent strategy - LIVE case
Provisional OCT-guided stent strategy on non-left main bifurcation
Summary
Learn more about a 65-year-old diabetic male patient with BMI 31, NYHA III shortness of breath, and a mid-calcified lesion on proximal and mid-part of LAD. QFR and µFR were significant for the 2 LAD lesions (0.73 and 0.74). The proximal lesion was a bifurcation Medina 1-0-1 with the first diagonal.
PCI was guided by OCT, with provisional stenting on the bifurcation (7F - predilatation - stenting - POT, no kissing), and a second stent on the mid-LAD lesion.
Imaging confirmed the need for preparation of the calcified lesion, with significant predilatation, stent size and landing zone, and helped ensure correct stent expansion, with the need for a second POT.
LIVE Case from Policlinico Universitario Fondazione Agostino Gemelli, Rome - Italy
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Key moments
- 06:57 - 11:35 - Procedural analysis
- 19:26 - 23:31 - OCT pre-PCI
- 23:33 - 1:13:38 - PCI
- 59:50 - 1:13:38 - OCT post-PCI
Keywords: Non-left main bifurcation, Provisional stenting, OCT, calcified lesion
Learning Objectives
- To understand when bifurcation lesion characteristics are favourable for the use of provisional stent strategy
- To learn the sequential steps of the provisional stenting strategy for bifurcation treatment
- To learn about the role of intracoronary imaging for optimisation of bifurcation treatment with the provisional strategy
