Provisional stenting for left main bifurcation disease under IVUS guidance: Case series my Cath lab philosophy

Instead of various developments in percutaneous coronary intervention (PCI), management of the bifurcation especially left main bifurcation (LM) is diffi cult and quite challenging.
In maximum number of patients who present with the LM bifurcation lesion, the one-stent strategy is the most preferred therapeutic option. However, with the objective to reduce the
risk of various peri-procedural complications such as side branch occlusion, physiological and anatomical assessment of the LM lesion should be done by using the intravascular imaging
techniques during the procedure. Here, we present the three cases of LM bifurcation which were successfully treated by using the provisional stenting method. All three cases were treated
with the guidance of the fractional fl ow reserve (FFR) and Intravascular Ultrasound (IVUS) and heart team considerations. Measurement of the fractional fl ow reserve was done to avoid
the risk of unnecessary complex interventions. At the three months follow-up, all patients were identifi ed as ischemia free.

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