Case Report

Lesions Close to Coronary Bifurcation and Different Angiographic Features

Authors: Erkan Gencer.

DOI: 10.33425/2639-8486.1221

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Abstract

Background: The optimal treatment strategy remains unclear for lesions located near, but not meeting the criteria for, typical coronary bifurcation lesions (CBL).

Case presentation: A 56-year-old male patient presented with persistent angina pectoris. Early coronary angiography (CAG) was performed due to high-risk features. A critical lesion was observed immediately before the circumflex artery (CX)- 3rd obtus marginalis (OM) bifurcation. The distance between the point of bifurcation (POB) and the severe stenosis (Minimal Lumen Diameter-MLD) was approximately 10 mm (MLD-POB distance ≤ 4 mm for the normal CBL definition). Provisional bifurcation percutaneous coronary intervention (PCI) was performed with the side- branch preservation owing to the presences of plaques with complex morphological features.

Conclusions: Anatomical challenges include plaque distribution extending to the POB, failure to determine a safe stent landing zone, or failure to predict plaque shift to the bifurcation point. These lesions, though not classical bifurcations, can be managed using bifurcation-specific strategies and techniques.

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