To the best of our knowledge, there is no study that evaluates the hemodynamic severity of bifurcation lesion, assessing FFR at both MV and SB initially. Finally, the deferral of PCI in functionally non-significant lesions in DEFER trial was associated with favourable outcomes in short- and long-term follow-up. Previous trials proved that FFR-guided PCI improved long-term outcomes in patients with stable coronary artery disease compared to angiography only or medical therapy. It is now accepted that measurements of fractional flow reserve (FFR) can identify haemodynamically significant lesions that require revascularisation. Previous studies showed that coronary angiography does not accurately predict the functional significance of the jailed side branches. What is more, there are some specific difficulties in angiographic assessment of bifurcation lesions due to the image foreshortening, vessel overlapping and presence of stent struts across the branch. Angiographic evaluation alone is sometimes imprecise and does not reflect the functional significance of lesions. Nevertheless, there is no established criterion as to which SB should be treated after main vessel stenting. The European Bifurcation Club recommends provisional single stent technique as the preferred strategy for most bifurcation lesions and recommends side branch (SB) stenting only if a significant flow limitation is present in a branch supplying a considerable myocardial territory. This occurrence is more notable for the era of bare metal stents (BMS) and early generation drug-eluting stents (DES). When compared with non-bifurcation interventions, bifurcation lesions have lower rate of procedural success and a higher rate of restenosis. Although during the last years significant progress has been made in interventional cardiology, bifurcation interventions remain a major therapeutic challenge with high early and late complication rates. Coronary bifurcation lesions represent nearly 20–25% of all percutaneous coronary interventions (PCI).
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