We can calculate that 2 million interventions worldwide are performed on bifurcation lesions per year. Publication of the 12^th consensus document from the European Bifurcation Club (EBC) (1) confirms that we are still looking for perfect bifurcation treatment. Analyzing eight general consensus statements and a number of consensus documents dedicated to specific topics published by EBC, the most important question in treating bifurcation lesion (BL) is the decision whether to implant one stent or two stents (simplicity or complexity). (2) This decision depends mostly on the operator’s subjective judgment of the true clinical relevance of a side branch.

We will review the present literature on how to differentiate simple from complex BL and critical analysis of clinical studies comparing provisional vs two stent techniques. We will present real world data from our medium volume center. We conclude and suggest:

These facts must be kept in mind in our search for holy grail in treating BL: technique that is fast, simple, easy, with less contrast and radiation, high success rates, low complications and good long-term results.