Percutaneous coronary intervention for bifurcation coronary lesions: the 15th consensus document from the European Bifurcation Club

Francesco Burzotta, Jens Flensted Lassen, Thierry Lefèvre, Adrian P Banning, Yiannis S Chatzizisis, Thomas William Johnson, Miroslaw Ferenc, Sudhir Rathore, Remo Albiero, Manuel Pan, Olivier Darremont, David Hildick-Smith, Alaide Chieffo, Marco Zimarino, Yves Louvard, Goran Stankovic

160 Citationer (Scopus)

Abstract

The 15th European Bifurcation Club (EBC) meeting was held in Barcelona in October 2019. It facilitated a renewed consensus on coronary bifurcation lesions (CBL) and unprotected left main (LM) percutaneous interventions. Bifurcation stenting techniques continue to be refined, developed and tested. It remains evident that a provisional approach with optional side branch treatment utilising T, T and small protrusion (TAP) or culotte continues to provide flexible options for the majority of CBL patients. Debate persists regarding the optimal treatment of side branches, including assessment of clinical significance and thresholds for bail-out treatment. In more complex CBL, especially those involving the LM, adoption of dedicated two-stent techniques should be considered. Operators using such techniques have to be fully familiar with their procedural steps and should acknowledge associated limitations and challenges. When using two-stent techniques, failure to perform a final kissing inflation is regarded as a technical failure, since it may jeopardise clinical outcome. The development of novel technical tools and drug regimens deserves attention. In particular, intracoronary imaging, bifurcation simulation, drug-eluting balloon technology and tailored antiplatelet therapy have been identified as promising tools to enhance clinical outcomes. In conclusion, the evolution of a broad spectrum of bifurcation PCI components has resulted from studies extending from bench testing to randomised controlled trials. However, further advances are still needed to achieve the ambitious goal of optimising the clinical outcomes for every patient undergoing PCI on a CBL.

OriginalsprogEngelsk
TidsskriftEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Vol/bind16
Udgave nummer16
Sider (fra-til)1307-1317
Antal sider11
ISSN1774-024X
DOI
StatusUdgivet - 19 mar. 2021

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