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Methods: Bench and in-vivo evaluations were performed. For the bench visualization bifurcated silicone mock vessel was used. The POKI technique 🌧️ was simulated using a 3.5 mm POT balloon. For the in-vivo evaluation patients with angiographic bifurcation lesions in a native 🌧️ coronary artery with diameter ≥ 2.5 mm and ≤ 4.5 mm, SB diameter ≥ 2.0 mm, and percentage diameter stenosis 🌧️ (%DS) more than 50% in the main vessel (MV) were included. Provisional stenting was the default strategy.

Background: Percutaneous coronary interventions 🌧️ (PCI) of bifurcation lesions poses a technical challenge with a high complication rate. Kissing balloon inflation (KBI) and proximal optimization 🌧️ technique (POT) are used to correct bifurcation carina after stenting. However, both may still lead to uncomplete strut apposition to 🌧️ the side branch (SB) lateral wall. Proposed herein, is a new stent-optimization technique following bifurcation stenting consisting of a combination 🌧️ of POT and KBI called proximal optimization with kissing balloon inflation (POKI).

This article is available in open access under Creative 🌧️ Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long 🌧️ as they credit the authors and the publisher, but without permission to change them in any way or use them 🌧️ commercially.

The article is accompanied by the editorial on page 894

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