Evolving bifurcation treatment practices: DCB, angio-based FFR and side branch optimisation

Sponsored by Medtronic

Anchorperson: G. Stankovic

Spokesperson: J. F. Lassen

Summary

This EuroPCR 2026 session explores the evolving landscape of bifurcation PCI, focusing on drug-coated balloon (DCB) strategies, angio-based fractional flow reserve (FFR) and side branch optimisation. It highlights how new evidence and physiology-guided tools are reshaping decision-making in this complex lesion subset.

Discussions include insights from the EBC DCB trial, with case-based examples of challenging scenarios such as ostial left main circumflex stenosis. The session also reviews emerging data supporting DCB use in bifurcation lesions, including results from the SCAAR Registry and ongoing comparisons between a step-wise provisional DES strategy and a DCB-only approach.

Real-world evidence from ALL-RISE is also highlighted, where bifurcation lesions represented 23.6% of cases with outcomes comparable to non-bifurcation lesions.

A key focus is the integration of physiology into practice.

CathWorks FFRangio is presented as a tool to support lesion assessment, procedural planning and post-procedural evaluation, helping optimise strategy selection and outcomes in bifurcation PCI.

Learning Objectives

To explore the challenge of ostial left main circumflex stenosis via practical cases
To review the latest updates from the EBC DCB trial and learn through case examples illustrating real-world applications
To understand how physiology-guided bifurcation PCI using CathWorks FFRangio can optimise decision making and improve patient outcome