Joint consensus on the use of OCT in coronary bifurcation lesions by European and Japanese bifurcation clubs.

Coronary artery bifurcation lesions comprise approximately 15-20% of all PCI and constitute a complex lesion subgroup. Intravascular optical coherence tomography (OCT) is a promising adjunctive tool for guiding coronary bifurcation with its unrivalled high resolution. Compared to angiography, intravascular OCT has a clear advantage to depict ostial lesion(s) in bifurcation without misleading 2-dimensional appearance of the conventional angiography such as overlap and foreshortening. In addition, OCT has the ability of reconstructing a bifurcation in three dimension and assessing the side branch ostium from 3D reconstruction of main vessel pullback, which can be applied to ensure the optimal recrossing position of the wire after main vessel stenting. Recently, on-line co-registration of OCT and angiography became widely available and helps the operator to position a stent in precise landing zones reducing the risk of geographic miss. Despite these technological advancements, the currently available clinical data are mainly based on observational studies with a small number of patients and there are few evidence from randomized trials. The joint working group of the European and the Japanese Bifurcation Club reviewed all the available literatures regarding OCT use in bifurcation lesions and provides recommendation on OCT guiding of coronary intervention in bifurcation lesions.