Coronary Bifurcation Stenting: Review of Current Techniques and Evidence

Abstract

Background: Coronary bifurcation stenting constitutes 20% of all PCI performed. Given the extensive prevalence of bifurcation lesions, various techniques have sought to optimally stent the bifurcation to improve revascularization while also decreasing rates of stent thrombosis and lesion recurrence. Advanced techniques, such as planned two-stent approaches, have been shown to have improved outcomes, but also require fluoroscopy and procedure time, posing an economical argument as well as a patient-outcome one. Objective: Because of the many strategies posited in the literature, it becomes essential to objectively evaluate evidence from randomized controlled trials and meta-analyses to help determine the optimal stenting strategy. Methods: We perform a review of the clinical evidence on the efficacy of coronary bifurcation stenting. Results: In this review, we review the most recent randomized controlled trials and meta-analyses on the efficacy of various stenting techniques and advances in stenting technologies published to gauge the current state of understanding, and chart where the field is heading. Conclusion: Bifurcation stenting is a maturing problem in the field of interventional cardiology that is adapting to the needs of the patients and advances in technology.