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Anatomical, physiological and clinical relevance of a side branch: Which branch really needs a stent?
European Bifurcation Club 2014 – EBC 2014 – Bordeaux, France
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Anatomical, physiological and clinical relevance of a side branch: Which branch really needs a stent?
Author: Bon-Kwon Koo, MD, PhD, Seoul National University Hospital, Seoul, Korea
SUMMARY
- If you want to do PCI for angiographically significant SB,
- Acknowledge that the side branch is different from the main branch.
- Assess the clinical relevance (myocardial mass at risk >10% by MPIestimation) of the side branch first.
- If you still want to do,
- Remind that there can be discrepancy between anatomical severity and physiological severity. When doubtful, measure FFR (Adequate experience and knowledge is required).
- Consider the possibility that the side branch is naturally protected.
- If you still want to do,
- Do it (very) well and be ready to use IVUS or OCT.