2-Year Outcome of Patients Treated for Bifurcation Coronary Disease With Provisional Side Branch T-Stenting Using Drug-Eluting Stents

Helen C. Routledge, Marie Claude Morice, Thierry Lefèvre, Philippe Garot, Federico De Marco, Beatriz Vaquerizo, Yves Louvard

Research output: Contribution to journalArticle

Abstract

Objectives: Our goal was to determine whether the deployment of drug-eluting stents (DES) in bifurcation lesions, according to a uniform provisional side-branch T-stenting strategy (PTS), is a safe and effective treatment in the immediate and long term. Background: In comparison with simple stenoses, successful percutaneous intervention for coronary bifurcation lesions is limited by a higher incidence of procedural complications and need for repeat revascularization. The ideal strategy to overcome these limitations remains to be demonstrated while recent controversy surrounds the long-term safety of DES in bifurcations. Methods: Consecutive patients treated for bifurcation lesions using DES were studied in a prospective single-center registry. Between 2003 to 2005, 477 procedures were performed. The PTS strategy was used in 92%, with a side-branch stent in 28% and final kissing balloon inflation in 95%. Results: Angiographic success was achieved in 99% with 2.5% in-hospital major adverse cardiac events. The cumulative rate of major adverse cardiac events was 10.7% at 1 year and 13.6% at 2 years, including 6.9% and 8.9% target vessel revascularization. Deviation from the PTS strategy independently predicted 2-year mortality (odds ratio: 5.5 [95% confidence interval: 1.63 to 18.3], p <0.01). The rate of definite or probable stent thrombosis at 2 years was 2.5% with half of all events occurring before hospital discharge. Conclusions: The PTS strategy for the treatment of bifurcation lesions is applicable to over 90% of patients in the real world. With DES, both safety and efficacy have been demonstrated in the long-term with

Original languageEnglish
Pages (from-to)358-365
Number of pages8
JournalJACC: Cardiovascular Interventions
Volume1
Issue number4
DOIs
Publication statusPublished - Aug 2008

Keywords

  • angioplasty
  • bifurcation lesions
  • drug-eluting stents
  • stent thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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