Coronary bifurcation lesions.

Treatment of coronary bifurcation lesions represents a challenging area in interventional cardiology, but recent advances in percutaneous coronary interventions have led to a dramatic increase in the number of patients successfully treated percutaneously. When compared with nonbifurcation interventions, bifurcation interventions have a lower rate of procedural success, higher procedural costs, longer hospitalization, and a higher rate of clinical and angiographic restenosis. The recent introduction of drug-eluting stents has resulted in a lower event rate and reduction of main vessel restenosis compared with historical controls. Side branch ostial residual stenosis and long-term restenosis remain a problem, however. Although stenting the main vessel with provisional side branch stenting seems to be the prevailing approach, in the era of drug-eluting stents, various two stent techniques have emerged to allow stenting of the large side branch also.