British Bifurcation Coronary Study

Objective: To compare the outcome of 2 treatment strategies for bifurcation lesions.

Study: Multicenter, randomized trial.Population: Patients with bifurcation lesion. Main branch

(MB) ≥ 2.5 mm, SB ≥ 2.25 mm. No AMI, No LM, No CTO.

End point: Composite of death, MI (CK > 3xULN), TVF (TVR MB a/o SB, TIMI flow < 3).

Enrolledn=500

Simple strategyProvisional T stenting

(if sidebranch> 70% DS, TIMI< 3)

n=250

Complex strategyCrush, Culotte

n=250

T stenting: n=7 (3%)Fluroscopy: 15 min 22 min p<0.001Proc. time: 57 min 78 min p<0.001

British Bifurcation Coronary Study

8,0

0,43,6

5,60,8

11,27,2

15,2

0

5

10

15

20

25

Composite death MI TVF

Simple Complex

p=0.009 p=0.001 p=0.43

British Bifurcation Coronary Study

Hildick-Smith et al. Circulation 2010;121:1235-43

Conclusion: Compared to provisional T stenting, a systematic 2 stent technique resulted in higher rates of 9 months MACE. Procedure duration an x-ray dose were higher in the complex strategy group.

British Bifurcation Coronary Study