ABSTRACT
INTRODUCTION Bifurcation lesions are frequent in routine practice, accounting for up to 20% of all coronary disease treated by percutaneous coronary intervention (1). Compared to the left main coronary artery bifurcation, the size of the vessels in non-left main bifurcations is smaller and the angle between them is narrower (2). On the basis of the results of six randomized controlled trials (RCTs) (3-8) (Fig. 1), in true coronary bifurcations with a short side branch lesion length, a stepwise provisional side branch stenting strategy with drug-eluting stents is consensually considered the preferable technique compared to deliberate elective double stenting (9). It is critically important to emphasize the statement “with a short side branch lesion length” since all these trials included bifurcations with side branches that have short lesions of moderate severity. Hence, these data cannot be presumed to apply to patients with coronary bifurcations who are not well represented in these trials (i.e., those with large side branches that have severe stenoses which are long or have unfavorable angulation).
