Bifurcation lesions in the context of a PCI CTO – insight from a Belgrade single-center CTO registry

Stefan Juričić; Milorad Tešić; Milan Dobrić; Siniša Stojković

doi:10.2298/VSP230116013J

Stefan Juričić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Milorad Tešić University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia
Milan Dobrić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Siniša Stojković University Clinical Center of Serbia, Clinic for Cardiology, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP230116013J

Keywords: coronary angiography, coronary occlusion, percutaneous coronary interventions, stents

Abstract

Background/Aim. Chronic total occlusions (CTOs) of the coronary artery are still one of the most complex procedures in the treatment of coronary arteries. If there is a bifurcation lesion within the CTO, it is certainly one of the biggest challenges for interventional cardiologists. Methods. We present a retrospective analysis of patients from our center who underwent percutaneous coronary intervention (PCI) with a bifurcation lesion within the CTO and a side branch with a diameter of 2 mm or more from January 2017 to December 2020. Results. Out of the total 216 patients in the four-year period, 38 (18%) had a bifurcation lesion within the CTO. The most common bifurcation lesions (50%) were on the left anterior descending artery, and the least frequent (21%) on the circumflex coronary artery. CTO recanalization was successful in 35 (92%) patients. The one-stent technique was used in 27 (77%) patients, while the two-stent technique was used in 8 (23%) patients. Conclusion. Bifurcation lesions in the context of PCI CTOs are a relatively common finding in coronary angiography and represent a special challenge for CTO operators. The provisional technique (one-stent technique) is the most common strategy for the treatment of bifurcation lesions in patients with CTO.

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