Key result
This editorial discusses the optimal stenting strategy for left main coronary bifurcation disease, comparing provisional one-stent versus upfront two-stent approaches.
Why the study?
Does an upfront two-stent approach improve outcomes compared to a provisional one-stent approach in patients with severe left main disease involving the distal bifurcation?
Does an upfront two-stent approach improve outcomes compared to a provisional one-stent approach in patients with severe left main disease involving the distal bifurcation?
Answers are grounded in this paper and cite their sources.
This editorial discusses the ongoing debate between provisional one-stent and upfront two-stent strategies for left main distal bifurcation lesions.
This editorial refers to ‘The European Bifurcation Club Left Main Coronary Stent study: a randomized comparison of stepwise provisional vs. systematic dual stenting strategies (EBC MAIN)’, by D. Hildick-Smith et al., doi:10.1093/eurheartj/ehab283. Simplicity, simplicity, simplicity! --Henry David Thoreau, Walden, 1854 Revascularization of severe left main disease is a class I guideline recommendation to improve survival.1 When percutaneous coronary intervention (PCI) is chosen as the method of revascularization, and the lesion involves the left main distal bifurcation, the age-old question remains—one or two stents upfront? In the past decade, Dr Shao-Liang Chen and colleagues have refuted Thoreau’s counsel, demonstrating elegantly in the DKCRUSH-V and DEFINITION II studies that left main bifurcation disease is better treated with an upfront two-stent approach rather than a provisional one-stent approach.2–4 However, these outstanding results were predicated on using the double kiss crush stenting, a technique that requires significant expertise to...
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Jaffer et al. (2021) conducted an editorial in Left main coronary disease at the bifurcation. Provisional stenting vs. Upfront two-stent approach was evaluated. This editorial discusses the optimal stenting strategy for left main coronary bifurcation disease, comparing provisional one-stent versus upfront two-stent approaches.
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