Antithrombotic therapy after percutaneous coronary intervention of bifurcation lesions

Marco Zimarino, Dominick J. Angiolillo, George Dangas, Davide Capodanno, Emanuele Barbato, Joo Yong Hahn, Gennaro Giustino, Hirotoshi Watanabe, Francesco Costa, Thomas Cuisset, Roberta Rossini, Dirk Sibbing, Francesco Burzotta, Yves Louvard, Abdulla Shehab, Giulia Renda, Takeshi Kimura, Hyeon Cheol Gwon, Shao Liang Chen, Ricardo CostaBon Kwon Koo, Robert F. Storey, Marco Valgimigli, Roxana Mehran, Goran Stankovic

Research output: Contribution to journalReview articlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)59-66
Number of pages8
JournalEuroIntervention
Volume17
Issue number1
DOIs
Publication statusPublished - May 2021

Keywords

  • Adjunctive pharmacotherapy
  • Bifurcation
  • Drug-eluting stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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