SCAI 2026 Bifurcation PCI Reimagined: Data-Driven Decisions in Complex Anatomy-0-0-1 PCI, Dr. Rab

Video Transcription

Video Summary

The talk focused on PCI strategies for bifurcation lesions, especially Medina 001 and 111 patterns. Dr. Raab argued that true ostial side-branch lesions often do best with drug-coated balloons (DCBs) after careful lesion preparation using cutting balloons, IVL, or other plaque-modifying tools. He emphasized intravascular imaging and pressure-wire assessment to confirm stability before DCB use. He noted high restenosis/MACE rates in left circumflex ostial disease and said the circumflex is a major PCI challenge. For simple bifurcations, DCBs reduced target lesion revascularization versus balloon angioplasty or stents. He also discussed sequencing, favoring DCB after preparation and before final provisional stenting in some cases.

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Keywords

PCI bifurcation lesions

Medina 001

Medina 111

drug-coated balloons

intravascular imaging