Shifting focus in bifurcations

The saga of bifurcation stenting strategies has entered a new chapter.

Recent findings question the provisional strategy (PS) as a first choice, supporting an upfront 2-stent (2S) deployment in complex true bifurcation lesions, notably for left main bifurcation disease1.

Several meta-analyses have been published comparing the PS to the 2S strategy, aiming to clarify findings from underpowered studies2. However, drawing accurate conclusions remains difficult. Various definitions and inclusion criteria for coronary bifurcation have been adopted, stent optimisation techniques (POT) and intravascular imaging have been heterogeneously used in randomised controlled trials (RCTs), newer-generation drug-eluting stents (DES) have been introduced ...