The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Antithrombotic Therapy after Percutaneous Coronary Intervention of Bifurcation Lesions

DOI: 10.4244/EIJ-D-20-00885

1. Institute of Cardiology, University "G. d'Annuzio" of Chieti-Pescara, Italy; 
2. Cath Lab, SS Annuziata Hospital, ASL2 Abruzzo, Chieti, Italy, Italy
3. Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA
4. the Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
5. Cardio-Thoracic-Vascular Department, Centro Alte Specialità e Trapianti, Catania, Italy. Azienda Ospedaliero Universitario "Vittorio Emanuele-Policlinico," University of Catania, Italy
6. Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy
7. Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
8. Kyoto University, Graduate School of Medicine, Department of Cardiovascular Medicine
9. Department of Clinical and Experimental Medicine, Policlinic "G Martino," University of Messina, Italy
10. Department of Cardiology, CHU Timone, Marseille, France
11. Cardiology, Ospedale Santa Croce e Carle, Cuneo, Italy
12. Privatklinik Lauterbacher Mühle am Ostersee, Iffeldorf, Germany and Department of Cardiology, Ludwig-Maximilians-University (LMU) München, Munich, Germany
13. Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
14. Ramsay Générale de Santé - Institut cardiovasculaire Paris Sud, Hopital Privé Jacques Cartier, Massy, France
15. Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, Abu Dhabi, United Arab Emirates
16. Nanjing First Hospital, Nanjing Medical University, Nanjing, China
17. Istituto Dante Pazzanese of Cardiology, Sao Paulo, SP, Brazil
18. Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
19. Cardiovascular Research Unit, Department of Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
20. Bern University Hospital, Bern, Switzerland.
21. Department of Cardiology, Clinical Center of Serbia, and Medical Faculty, University of Belgrade, Belgrade, Serbia

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Coronary bifurcations exhibit localized turbulent flow and enhanced propensity for atherothrombosis, platelet deposition and plaque rupture. Percutaneous coronary intervention (PCI) of bifurcation lesions is associated with an increased risk of thrombotic events. Such risk is modulated by anatomical complexity, intraprocedural factors and pharmacological therapy. There is no consensus on the appropriate PCI strategy or the optimal regimen and duration of antithrombotic treatment in order to decrease the risk of ischemic and bleeding complications in the setting of coronary bifurcation. A uniform therapeutic approach meets a clinical need.

The present initiative, promoted by the European Bifurcation Club (EBC), involves opinion leaders from Europe, America, and Asia with the aim to analyze the currently available evidence. Although mainly derived from small dedicated studies, sub-studies of large trials or from authors' opinions, an algorithm for the optimal management of patients undergoing bifurcation PCI, developed on the

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