Comparison Between Main Branch and Side Branch Vessels

Study Overview
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Brief Summary
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The purpose of this trial is to compare the clinical significance of the main vessel and the side branch vessel using EKG, pain score and coronary wedge pressure to develop a new scoring system to predict the clinical significance of a side branch

Detailed Description
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Clinical significance EKG change, pain score during 1 min balloon occlusion Different characteristics between ST segment elevation vs non-elevation side branches Comparison of coronary wedge pressure Establishing a new scoring system to predict the ST elevation during 1min balloon occlusion

Official Title
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Comparison of Clinical, Electrical and Physiologic Significance Between Main Branch and Side Branch Vessels

Conditions
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Coronary Artery Disease

Intervention / Treatment
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* Other: Measuring collateral flow


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 Able to verbally confirm understandings of risks, benefits of receiving percutaneous coronary intervention (PCI) for true bifurcation lesions, and he/she or his/her legally authorized representative provides written informed consent prior to any study related procedure Significant stenosis at bifurcation lesion (>50% by visual estimate) which always includes stenosis of side branch (true bifurcation) Target main branch lesion(s) located in a native coronary artery with diameter of ≥ 2.5 mm and ≤ 4.5 mm. Target side branch lesion(s) in a native coronary artery with diameter of ≥ 2.25 mm Target lesion(s) amenable for PCI with final kissing balloon angioplasty for the side branch Exclusion Criteria: Non-cardiac co-morbid conditions are present with life expectancy <1 year or that may result in protocol non-compliance (per site investigator's medical judgment) Patients refuse to give informed consent Patients with left main coronary artery stenosis Patients with total occlusion of the bifurcation lesion Patients with infarct-related artery at the lesion of interest Patients with left ventricular ejection fraction<40% Patients with primary cardiomyopathy Patients with chronic kidney disease defined as serum Cr>2.0 Patients who have severe side effects or contraindication to adenosine

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Main vessel, side branch vessel<br> | Other: Measuring collateral flow<br>* Measuring collateral flow using pressure and/or velocity coronary wire<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ST elevation during 1min balloon occlusion |  | Day 1 after PCI | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain score during 1min balloon occlusion |  | Day 1 after PCI | 
| coronary wedge pressure |  | during the procedure | 
| Usefulness of new scoring system | New scoring system includes the vessel size, myocardial territory and relationship with neighboring branches | During the procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Coronary artery disease, Bifurcation, Myocardial infarction, Myocardial ischemia, Collateral