Multivessel Balloon Occlusion to Investigate Obstructive Coronary Artery Disease and aNgina

Inclusion Criteria:

• Eligibility for PCI due to angina

• Anatomical evidence of significant multi-vessel coronary stenosis defined by either:

1. ≥70% stenosis in two or more coronary arteries of ≥2.5mm visual diameterstenosis, on invasive coronary angiography (ICA)

2. Severe stenosis in ≥2 coronary arteries of ≥ 2.5mm visual diameter stenosis, onCTCA

• Physiological evidence of ischaemia with a positive test corresponding to thecoronary arteries to be stented, on at least one of the following:

• dobutamine stress echocardiogram

• cardiac MRI

• myocardial perfusion study

• invasive metrics of coronary physiology

Exclusion Criteria:

• Recent acute coronary syndrome

• Previous coronary artery by-pass graft surgery (CABG)

• Significant left main stem disease

• Chronic total occlusion in the target artery(s)

• Moderate to severe valvular disease

• Moderate to severe left ventricular impairment

• Contraindication to PCI or a drug-eluting stents

• Contraindication to antiplatelet therapy

• Contraindication to adenosine

• Pregnant

• Inability to consent