Perspective on bifurcation PCI

Abstract

Coronary bifurcation lesion is a complex lesion with suboptimal angiographic and clinical results. There has been no satisfactory classification of the lesion that can guide selection of strategies and predict short- and long-term outcomes. The difference between left main (LM) bifurcation lesions and non-LM bifurcation is striking. So many stenting strategies have been proposed and tried in trials. They include the V, T, Y, one-stent, two-stent, crush, mini-crush, DK, and SKS techniques. However, because these techniques are time and labor intensive, dedicated bifurcated stents have been invented and trialed in humans. This review presents a historical perspective of interventions in bifurcated lesions, with the strengths and weaknesses of the major strategies and of the new dedicated stents. ©2009, Wiley Periodicals, Inc.