News Release 

Randomization of provisional vs two-stent techniques in complex bifurcation lesions

Provisional stenting for complex coronary bifurcation stenosis: no longer the default procedure?


Aim: The present study aimed to assess the benefits of two-stent techniques for patients with DEFINITION criteria-defined complex coronary bifurcation lesions.

Methods and Results: In total, 653 patients with complex bifurcation lesions at 49 international centres were randomly assigned to undergo the systematic two-stent technique (two-stent group) or provisional stenting (provisional group). The primary endpoint was the composite of target lesion failure (TLF) at the 1-year follow-up, including cardiac death, target-vessel myocardial infarction (TVMI), and clinically driven target lesion revascularization (TLR). The safety endpoint was definite or probable stent thrombosis (ST).

At the 1-year follow-up, TLF occurred in 37 (11.4%) and 20 (6.1%) patients in the provisional and two-stent groups, respectively (77.8%: DK crush; hazard ratio [HR]: 0.52, 95% confidence interval [CI]: 0.30-0.90; p = 0.019), largely driven by increased TVMI (7.1%, HR: 0.43, 95% CI: 0.20-0.90, p = 0.025) and clinically driven TLR (5.5%, HR: 0.43, 95% CI: 0.19-1.00, p = 0.049) in the provisional group. At the 1-year after indexed procedures, the incidence of cardiac death was 2.5% in the provisional group, non-significant to 2.1% in the two-stent group ([HR]: 0.86, 95% CI: 0.31-2.37, p = 0.772).

Conclusion: For DEFINITION criteria-defined complex coronary bifurcation lesions, the systematic two-stent approach was associated with a significant improvement in clinical outcomes compared with the provisional stenting approach. Further study is urgently warranted to identify the mechanisms contributing to the increased rate of TVMI after provisional stenting


Notes to editors

Key information

    o A PCR Press Release on Multicentre, Randomised Comparison of Two-Stent and Provisional Stenting Techniques in Patients with Complex Coronary Bifurcation Lesion by Shao-Liang Chen

    o Presentation during the #PCR e-Course -

    o Session on Main Arena Channel, Friday 26 June - 14:16 Paris time (UTC+2)

    o PCR e-Course: 25, 26, 27 June 2020

About PCR

The mission of PCR is to serve the needs of each individual patient by helping the cardiovascular community to share knowledge, experience and practice. PCR offers a wide range of other educational meetings and resources for the continuing education of the interventional cardiovascular community. These include major annual Courses across the globe, e-Learning with high-profile PCR Webinars, Courses specifically dedicated to valvular heart disease, tailor-made PCR Seminars on specific topics, online resources and medical publications such as EuroIntervention, the official journal of the EAPCI.

Gateways to all PCR activities are available on

For further information, please contact Célia Vilà:

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.