Effect of side branch predilatation before provisional stenting in coronary bifurcation lesions

Aim: Percutaneous coronary intervention (PCI) for bifurcation lesions remains technically challenging.Despite the development of single-stent provisional techniques and various dual-stent strategies, the problem of side branch (SB) occlusion and restenosis remains unresolved.In our study, we aimed to compare the side branch (SB) patency at the end of the procedure in patients with bifurcation lesions and significant SB disease, undergoing provisional stenting, with and without SB predilatation.Materials and Methods: This retrospective observational study included 115 patients who underwent provisional PCI for true bifurcation lesions between January 2021 and November 2024.Patients were divided into two groups: those who received SB predilatation before provisional stenting and those who did not.Results: The mean age of the 115 patients in our study was 64.6 10.4 years, and 31% were female.In the predilatation group, SB lesion severity, procedure duration, dissection rate, and kissing balloon requirement were significantly higher compared to the non-predilatation group (p < 0.05).Discussion: Our study showed that routine SB predilatation during provisional stenting of true bifurcation lesions is associated with higher rates of dissection and kissing balloon requirement.Similar to the literature, routine SB predilatation does not appear to be recommended.The use of NC balloons in predilatation may be beneficial, as it may reduce dissection rates.Large-scale studies with a high number of patients will be helpful in further elucidating these findings.