Major limitations of randomized clinical trials involving coronary artery bifurcation interventions: Time for redesigning clinical trials by involving only true bifurcation lesions and using appropriate bifurcation classification

Coronary bifurcation lesion intervention is technically challenging with higher complication rates. Many coronary interventional trials have been conducted involving coronary bifurcation lesions in order to compare one-stent with two-stent techniques. However, these trials have major limitation by enrolling all bifurcation lesions, including low-risk lesions so-called not true bifurcation lesions. This manuscript discusses the importance of appropriate designing of clinical trials for evaluation of complex techniques in coronary bifurcation lesions.