Figure 1. Summary of Bif-ARC Recommendations. After identifying a bifurcation lesion, this should be classified according to MEDINA classification and the left main (LM) involvement.

Dedicated bifurcation quantitative coronary analysis (QCA) is strongly advised to be used by sites and core laboratories for quantitative assessment. To evaluate the eligibility of the lesion in a bifurcation trial, its side branch (SB) should be proven to be clinically relevant through different diagnostic techniques according to their availability in the center and the quality and type of the study. The Bifurcation Academic Research Consortium (Bif-ARC) recommends 6 classes of study type, based on the investigation. For every category of study, dedicated endpoints are provided and classified in 3 groups. The follow-up includes clinical, noninvasive, and invasive assessment.