Introduction:

Percutaneous coronary intervention (PCI) in bifurcation lesions remains complex in many respects. Part of the complexity relates to the variety of situations, definitions, treatment and outcomes which are related to this anatomical configuration.

In order to develop a consensual view on the many aspects of coronary bifurcation lesions, the European Bifurcation Club (EBC) was created in 2004. The first EBC meeting took place in Bordeaux in 2005 and some consensus emerged.

Briefly, the participants agreed that:

a) the Medina classification should be adopted,

b) with bare metal stents, a stepwise provisional T-stent strategy is the gold standard,

c) with bare metal stents, deliberate double-stenting may be an inferior technique,

d) with drug- eluting stents, the optimal strategy is under development and ongoing trials (Nordic and BBC1) will help to define it,

e) after complex stenting, kissing balloon inflations should be routinely performed.

Several problems were still unsolved, however. Some of the debated issues as well as the previously adopted ideas were discussed, with respect to the recent clinical and technical developments, during the second EBC meeting which was held in Rome on September 29th to 30th, 2006.

This manuscript highlights the discussions, disputes and consensus which emerged from this meeting.