“Leave Nothing Behind”: Is It a Dream?

Despite advances in Drug-Eluting Stent (DES) technology, at 10-year followup there has been no significant difference between DES and Bare-Metal Stent (BMS) in terms of target-lesion revascularization or stent thrombosis (P =.7). 1 After about 18 months, a DES is essentially nothing more than a metallic implant and a source of reaction-inflammation.These long-term adverse features of DES have given rise to the "Leave Nothing Behind" hypothesis.The European Bifurcation Club's Keep it Simple, Swift, and Safe (KISS) principle guides the main treatment approach.Although stenting the main branch with provisional side-branch stenting remains the basic strategy, carinal shift and significant side-branch ostial narrowing sometimes make this impossible.