Drug-coated Balloon in Side Branch with Main Branch Stenting Versus Provisional Two-stent Strategy in the Treatment of Left Main Bifurcation Lesion

Background: The Left circumflex (LCx) artery serves as the side branch (SB) at the left main (LM) bifurcation; this artery is commonly angular and has a large average diameter, making it difficult to treat. In order to treat left main bifurcation lesions, this study analyzes the safety and effectiveness of DES with DCB compared to the traditional two-stent approach. Aim: To evaluate clinical, anatomical, and procedural outcomes of combining main branch (MB) stenting with side branch (SB) drug-coated balloon (DCB) in comparison with the two-stent strategy in treating LM bifurcation lesions. Subjects and methods: From April 2023 through April 2025, 60 consecutive patients with LM bifurcation lesions detected by coronary angiography were part of this prospective study at Al-Azhar University's cardiology department and medical school. Results: There was no significant difference between the two groups in terms of LAD luminal stenosis (LS) as measured by Mean±SD (6.96±1.81%) and (6.79±1.61%) in group I and group II, respectively, when it came to immediate postoperative findings (p=0.699). Nevertheless, the mean±standard deviation for LCx luminal stenosis in group I was 14.13±2.72%, while in group II it was 12.03±2.29% (p=0.002). The MPI results at LCx were better in group I during the follow-up period (p=0.04). Conclusion: A safe and effective technique for treating true LM bifurcation lesions is a combination of DES in MB and DCB in SB.