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Why the provisional single-stent approach is not always the right strategy; arguments for the development of dedicated bifurcation devices

1. Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; 2. Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

Bifurcation lesions are present in 15 to 20% of the patients undergoing percutaneous coronary interventions (PCI)1,2 and are associated with increased rates of in-stent restenosis3 and stent thrombosis4.

The current consensus in the treatment of bifurcation lesions is to use the provisional single stent approach as the default strategy5. This consensus is based on large randomised trials, comparing single- with two-stent techniques, such as the Nordic6, CACTUS7 and BBC-18 trials (Table 1). Of these trials, Nordic and CACTUS showed similar clinical outcomes with single stenting when compared with…

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