Why the study?
There is no consensus on the appropriate PCI strategy or the optimal regimen and duration of antithrombotic treatment to reduce ischaemic and bleeding complications after coronary bifurcation PCI.
What is the optimal regimen and duration of antithrombotic treatment to decrease the risk of ischaemic and bleeding complications in patients undergoing PCI of bifurcation lesions?
What is the optimal regimen and duration of antithrombotic treatment to decrease the risk of ischaemic and bleeding complications in patients undergoing PCI of bifurcation lesions?
This consensus document provides a proposed algorithm for tailoring antithrombotic therapy in patients undergoing bifurcation PCI based on clinical presentation, bleeding risk, and procedural strategy.
May guide individualized DAPT after bifurcation PCI by presentation and risk; leaves open dedicated randomized validation.
Coronary bifurcations exhibit localised turbulent flow and an enhanced propensity for atherothrombosis, platelet deposition and plaque rupture. Percutaneous coronary intervention (PCI) of bifurcation lesions is associated with an increased risk of thrombotic events. Such risk is modulated by anatomical complexity, intraprocedural factors and pharmacological therapy. There is no consensus on the appropriate PCI strategy or the optimal regimen and duration of antithrombotic treatment in order to decrease the risk of ischaemic and bleeding complications in the setting of coronary bifurcation. A uniform therapeutic approach meets a clinical need. The present initiative, promoted by the European Bifurcation Club (EBC), involves opinion leaders from Europe, America, and Asia with the aim of analysing the currently available evidence. Although mainly derived from small dedicated studies, substudies of large trials or from authors' opinions, an algorithm for the optimal management of patients undergoing bifurcation PCI, developed on the basis of clinical presentation, bleeding risk, and intraprocedural strategy, is proposed here.
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Zimarino et al. (2021) conducted a review in Coronary bifurcation lesions undergoing percutaneous coronary intervention. Antithrombotic therapy was evaluated. An individualized antithrombotic therapy algorithm for patients undergoing bifurcation PCI was developed based on clinical presentation, baseline bleeding risk, stenting strategy, and imaging.
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