Two-stent techniques for the treatment of coronary bifurcations with drug-eluting stents.

coronary interventions (PCI) and the recent introduction of drug-eluting stents (DES) have led to a dramatic increase in the number of patients treated percutaneously. Bifurcation lesions are one of the complex lesion subsets that are now being confronted more frequently. Repeated studies have shown that bifurcation interventions, when compared to non-bifurcation procedures, have a lower rate of procedural success and a higher rate of restenosis. Various techniques making use of one or two stents have been developed to optimise the treatment of this subset of lesions. Paradoxically, while stenting of individual lesions has been shown to be superior to balloon angioplasty, stenting of both branches seems to offer no advantage over stenting of the main branch (MB) alone. The recent introduction of DES has resulted in a lower event rate and a reduction of MB restenosis in comparison with historical controls. However, side branch (SB) ostial restenosis remains a problem.