Complex percutaneous coronary intervention techniques and procedural success have improved significantly over the last two decades. Bifurcation lesions make up about 15–20 % of all coronary interventions [ 1 ] and constitute a particularly challenging subset of complex interventions. Optimal treatment of bifurcation lesions is most often achieved in experienced centers that can achieve procedural success and improve long term hard clinical outcomes. Technical challenges in bifurcation coronary interventions include caliber of the main branch compared to the side branch, side branch lesion length and complexity including amount of calcification, need for specialized plaque modification devices, side branch occlusion risk, myocardium at risk of ischemia and bifurcation angle [ 2 ].