The 15th European Bifurcation Club (EBC) meeting was held in Barcelona in October 2019. It facilitated a renewed consensus on coronary bifurcation lesions (CBL) and unprotected left main (LM) percutaneous interventions. Bifurcation stenting techniques continue to be refined, developed and tested. It remains evident that a provisional approach with optional side branch treatment utilising T, T and small protrusion (TAP) or culotte continues to provide flexible options for the majority of CBL patients. Debate persists regarding the optimal treatment of side branches, including assessment of clinical significance and thresholds for bail-out treatment. In more complex CBL, especially those involving the LM, adoption of dedicated two-stent techniques should be considered. Operators using such techniques have to be fully familiar with their procedural steps and should acknowledge associated limitations and challenges. When using two-stent techniques, failure to perform a final kissing inflation is regarded as a technical failure, since it may jeopardise clinical outcome. The development of novel technical tools and drug regimens deserves attention. In particular, intracoronary imaging, bifurcation simulation, drug-eluting balloon technology and tailored antiplatelet therapy have been identified as promising tools to enhance clinical outcomes. In conclusion, the evolution of a broad spectrum of bifurcation PCI components has resulted from studies extending from bench testing to randomised controlled trials. However, further advances are still needed to achieve the ambitious goal of optimising the clinical outcomes for every patient undergoing PCI on a CBL. Visual summary. 15th consensus document from the European Bifurcation Club.
Bibliografisk noteFunding Information:
received institutional funding of a fellowship from Boston Scientific and speaker fees from Boston, Abbott, Medtronic, Philips/Volcano and Miracor. T.W. Johnson has received speaker fees from Abbott, Boston Scientific, Medtronic, and Terumo, and institutional funding for fellowships from Boston Scientific and Terumo. D. Hildick-Smith has received advisory board/consultancy/research funding from Terumo, Medtronic, Abbott, and Boston Scientific. R. Albiero has received speaker fees from Medtronic and Abbott. M. Pan has received speaker fees from Abbott, Terumo and Volcano. A. Chieffo has received speaker fees from Abiomed and GADA. O. Darremont has received speaker fees from Edwards. Y.S. Chatzizisis has received speaker fees, consultation fees and research grant from Boston Scientific, and research support from Medtronic. T. Lefèvre has received speaker fees from Abbott, Medtronic and Terumo. The other authors have no conflicts of interest to declare.