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Restenosis and target-vessel revascularization rates are lower with DES compared with BMS, although mortality and stent thrombosis rates are similar (725). The use of covered stents is limited to the treatment of the uncommon complication of SVG perforation. Balloon angioplasty for distal SVG anastomotic stenoses has low LOXO-101 cost restenosis rates (724), so stenting is commonly reserved at this location for suboptimal balloon angioplasty results or restenosis. Routine GP IIb/IIIa inhibitor therapy has not proven beneficial in SVG PCI (720). Fibrinolytic therapy is no longer used for thrombus-containing lesions, but rheolytic or manual aspiration thrombectomy is sometimes employed. CLASS I 1 Provisional side-branch stenting should be the initial approach in patients with bifurcation lesions when the side branch is not large and has only mild or moderate focal disease at the ostium (726, 727, 728?and?729). (Level of Evidence: A) CLASS IIa 1 It is reasonable to use elective double stenting in patients with complex bifurcation morphology involving a large side branch tuclazepam where the risk of side-branch occlusion is high and the likelihood of successful side-branch reaccess is low (730, 731, 732?and?733). (Level of Evidence: B) Side-branch occlusion or severe stenosis after stenting the main artery in coronary bifurcation PCI occurs in 8% to 80% of unselected patients (732?and?734). The frequency of side-branch occlusion is related to complex bifurcation morphology (severe and/or long side-branch ostial stenosis, large plaque burden in the side-branch ostium, and/or unfavorable side-branch angulation) (732, 735?and?736). Side-branch occlusion after PCI is associated with Q-wave and non�CQ-wave MI (734?and?735). Therefore, preservation of physiologic flow in the side branch after PCI is important (736). There are 2 bifurcation PCI strategies: provisional stenting (stenting the main vessel with additional http://www.selleckchem.com/products/bms-911543.html balloon angioplasty or stenting of the side branch only in the case of an unsatisfactory result) and elective double stenting of the main vessel and the side branch. When there is an unsatisfactory result in the side branch from the provisional stent in the main branch, sometimes balloon angioplasty alone in the side branch will improve the result and stenting the side branch is not necessary. Some experts have suggested that using the side-branch balloon alone will distort the main branch stent and thus this always needs to be a kissing balloon inflation. In patients with low-risk bifurcation lesions (minimal or moderate ostial side-branch disease [