Balloons and stent sizing for bifurcation PCI Role of Intra-coronary Imaging

CORONARY BIFURCATION IMAGING

• Device sizing (general):
  • EEL-based reference diameter measurement is firstly recommended.
  • In case of invisible EEL, lumen-based measurement is also available.
  • For the optimal stent landing zone, it is important to avoid dissection, > 50% plaque burden, and lipid pool.
• Device sizing: bifurcation lesion
  • POT and KBI balloon should be selected according to vascular branching law.
  • In the bifurcation lesion, Finet’s law is applicable for imaging-guide reference diameter measurement, not for angio-based one.
  • Stent should be selected considering maximal expansion capacity.
  • Minimum expansion index considering vascular branching and tapering is more physiological to select post-dilation site and appropriate balloon.