Theodoros Vichos, Michaella Alexandrou, Dimitrios Strepkos, Pedro E P Carvalho, Marios Tsourous, Ahmet Akyel, Noah Nick Willford, Oleg Krestyaninov, Dimitri Khelimskii, Barkin Kultursay, Ali Karagoz, Ufuk Yildirim, Korhan Soylu, Mahmut Uluganyan, Kadriye O Kilickesmez, Gokhan Cetinkal, Sefa Sural, Olga Mastrodemos, Bavana V Rangan, Yader Sandoval, Emmanouil S Brilakis
Side branch (SB) wire jailing before main vessel (MV) stenting is widely used during provisional bifurcation percutaneous coronary intervention (PCI), but its benefit remains unclear. We analyzed 1,485 patients (1,628 lesions) who underwent provisional bifurcation PCI at 10 centers between 2013 and 2026 from the Prospective Global Registry for the Study of Bifurcation Lesion Interventions and compared procedural and clinical outcomes according to whether wire jailing of the SB was performed before MV stenting. Wire jailing was performed in 818 lesions (50.2%). Compared with non-wire-jailed lesions, they had higher technical success (odds ratio [OR] 4.60; 95% confidence interval [CI] 2.79-8.00; p<0.001) and procedural success (OR 2.34; 95% CI 1.61-3.46; p<0.001), and lower final SB occlusion (OR 0.14; 95% CI 0.04-0.37; p<0.001). After multivariable adjustment with inverse probability of treatment weighting (IPTW), wire jailing remained independently associated with higher technical success (OR 3.81; 95% CI 1.93-7.51; p<0.001), higher procedural success (OR 1.93; 95% CI 1.15-3.22; p=0.012), and lower final SB occlusion (OR 0.03; 95% CI 0.01-0.19; p<0.001). In-hospital major adverse cardiovascular events (MACE) were similar between groups (IPTW-adjusted OR 1.27; 95% CI 0.60-2.70; p=0.533). During a median follow-up of 850 days, the incidence of MACE, all-cause mortality, myocardial infarction, and target-vessel revascularization were similar between groups. In conclusion, wire jailing of the SB was associated with higher technical and procedural success and lower rates of final SB occlusion, with similar in-hospital and long-term MACE.