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Methods: Bench and in-vivo evaluations were performed. For the bench visualization bifurcated silicone mock vessel was used. The POKI technique 🧲 was simulated using a 3.5 mm POT balloon. For the in-vivo evaluation patients with angiographic bifurcation lesions in a native 🧲 coronary artery with diameter ≥ 2.5 mm and ≤ 4.5 mm, SB diameter ≥ 2.0 mm, and percentage diameter stenosis 🧲 (%DS) more than 50% in the main vessel (MV) were included. Provisional stenting was the default strategy.

Background: Percutaneous coronary interventions 🧲 (PCI) of bifurcation lesions poses a technical challenge with a high complication rate. Kissing balloon inflation (KBI) and proximal optimization 🧲 technique (POT) are used to correct bifurcation carina after stenting. However, both may still lead to uncomplete strut apposition to 🧲 the side branch (SB) lateral wall. Proposed herein, is a new stent-optimization technique following bifurcation stenting consisting of a combination 🧲 of POT and KBI called proximal optimization with kissing balloon inflation (POKI).

This article is available in open access under Creative 🧲 Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long 🧲 as they credit the authors and the publisher, but without permission to change them in any way or use them 🧲 commercially.

The article is accompanied by the editorial on page 894

Introduction