Coronary bifurcations in clinical practice: Tell me what we can do better

Area of Science:

• Cardiovascular medicine
• Interventional cardiology
• Medical imaging

Background:

• Bifurcation lesions require precise evaluation for severity and extension.
• Quantitative coronary angiography is essential for accurate assessment of these complex lesions.
• Intravascular imaging has demonstrated benefits in guiding percutaneous coronary intervention (PCI) for bifurcation lesions, reducing clinical events.

Discussion:

• The optimal strategy for PCI in bifurcation lesions remains an area of active research.
• Intravascular imaging provides detailed anatomical and physiological information beyond angiography.
• The role of intravascular imaging in improving PCI outcomes in bifurcation lesions is increasingly recognized.

Key Insights:

• Accurate assessment of bifurcation lesion severity and extension is critical.
• Intravascular imaging is a valuable tool for guiding PCI in bifurcation lesions.
• Clinical events can be reduced by using intravascular imaging during PCI for bifurcations.

Outlook:

• Further research is needed to determine the optimal selection and duration of dual antiplatelet therapy post-PCI for bifurcation lesions.
• Investigating novel imaging modalities and techniques for bifurcation assessment is warranted.
• Long-term outcomes and cost-effectiveness of intravascular imaging-guided PCI for bifurcations require continued evaluation.