Percutaneous Treatment of Coronary Bifurcation Lesions

Abstract

Coronary bifurcations remain one of the most challenging lesions in interventional cardiology in terms of procedural success rate and long-term adverse cardiovascular events.1 Although numerous techniques and devices have been proposed to address the treatment of bifurcation lesions, there are 2 primary interventional strategies commonly used: one is a more complex approach that implies the systematic implantation of a stent in both the main vessel and the side branch (SB), and the other is the provisional T-stent, consisting in stenting the main vessel only, with the option to place a stent in the SB, if necessary. Provisional stenting often results in worse angiographic performances, but it offers several advantages compared with other more complex techniques: it is simple to perform in most cases, and it is associated with a lower rate of acute and late complications, as well as costs.1 Therefore, in clinical practice, the provisional approach is widely accepted as the default technique in the majority of bifurcation lesions.1 See Article by Hildick-Smith et al In the past decade, several randomized trials have been conducted, using different type of stents and techniques, demonstrating comparable clinical outcome between provisional and 2-stent approaches for the treatment of bifurcations.2–7 Despite …