In this #europcr 2025 video, Nicola Ryan speaks with Dejan Milasinovic about when and how to adopt an upfront two-stent strategy in bifurcation PCI.

The key is assessing the side branch: if stenosis is high-grade and disease is extensive, treatment may be needed from the start—using POBA, a DCB, or a second stent. Anatomy should guide the choice between a provisional or two-stent approach.

Intracoronary imaging is essential to detect issues like abluminal rewiring and stent distortion, especially when treating the side branch. As highlighted by the OCTOBER trial, proper rewiring and final stent architecture are crucial to reduce the risk of long-term complications.

Find out how to tailor your approach to each bifurcation scenario.

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