Two stents, too many? Should provisional PCI be the default bifurcation strategy?


Take Home Messages
  • Bifurcation lesions pose added complexity and risk in PCI.
  • There are conflicting data regarding when and what type of bifurcation strategy to utilize.
  • This article summarises recent trials relating to bifurcation PCI and attempts to distal the key points for the reader.

The European Bifurcation club (EBC) defines a coronary bifurcation lesion as a “coronary artery narrowing occurring adjacent to, and/or involving, the origin of a significant side branch (SB)”. A significant SB is a “branch that one does not want to lose in the global context of a particular patient” (1). There are several methods of classification; however, the medina classification (Figure 1) is widely accepted with a ‘true bifurcation’ lesion defined as Medina class (1,0,1), (1,1,1), or (0,1,1) (2).