The simple strategy with a provisional stent is now favored to treat bifurcation lesions; however, stent implantation in the main branch can compromise or even occlude the side branch. Pre-dilation of the side branch could lower the chances of this happening. We included 372 patients with bifurcation lesions (Medina 111, 011 and 101); the technique used was provisional stenting with DES. After advancing the guide through the side branch, there was a 1:1 randomization to pre-dilation of the branch or not. The primary endpoint was TIMI flow in the side branch after stenting of the main branch. There was a significant difference in the need for post side branch dilation in favor of the pre-dilation group (68 versus 100, p=0.001) and in the TIMI flow post-stenting.
Conclusion: Pre-dilation of the side branch in cases of bifurcation lesions with provisional stent technique improves post-stenting TIMI flow in the side branch and thus the need to rescue this branch.
Manuel Pan
2013-05-23
Original title: Pre-dilation of side branch during percutaneous treatment of bifurcation lesions with provisional T-stenting.