BACKGROUND: Treatment of coronary bifurcation lesions is a complex problem. METHODS: This retrospective single-center study included all consecutive patients with PCI of coronary bifurcations with stent covering of the side branch (SB) between January 2008 - August 2011.Two methods were compared: group A represented patients without treatment of SB, group B were patients with treatment of SB. RESULTS: Our study group (n = 98) was group A (n = 64, 65.3%) and group B (n = 34, 34.7%). Mean follow-up was 14.1 (group A) vs 12.3 (group B, p = ns) months.Mean age (years) was 70.3 (group A) vs. 67.0 (group B, p = ns), NSTEMI/STEMI was present in 54.7% (group A) vs. 41,2% (group B, p = ns).Duration of x-raying (min, group A vs group B) and the amount of contrast medium (ml) were significantly lower in group A: 18.1 min vs 20.1 min and 225.8 ml vs 307.4 ml (p < 0.05).Final TIMI flow III inside the MB was reached in 98.4% (group A) vs. 97.1% (group B, p = ns), inside the SB in 84.4% vs. 94.1% (p = ns).Target lesion revascularization and target vessel revascularization was seen in 15.9% (group A) vs 32.4% (group B, p = 0.07), cardiac death in 7.9% (group A) vs 14.7% (group B, p = 0.3).All MACE revealed were: 23.8% (group A) vs. 47.1% (group B, p = 0.02). CONCLUSION: In patients with coronary bifurcations a simpler strategy has a significantly lower MACE.Trial registration: ClinicalTrials.gov Identifier: NCT01538186.