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Anatomical, physiological and clinical relevance of a side branch: Which branch really needs a stent?

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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.

 

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