Impacto da pré-dilatação do ramo lateral no procedimento de intervenção coronária percutânea em lesões de bifurcação coronária complexas

Translated title of the contribution: Impact of side branch predilation on percutaneous coronary intervention in complex coronary bifurcation lesions

Ricardo A. Costa, Fausto Feres, Rodolfo Staico, J. Ribamar Costa, Dimytri Siqueira, Luiz F. Tanajura, Alexandre Abizaid, Amanda G M R Sousa, J. Eduardo Sousa, Antonio Colombo

Research output: Contribution to journalArticlepeer-review

Abstract

The treatment of coronary bifurcation lesions with single stenting in the main vessel and provisional side branch stenting may be limited by the degree of anatomical/ morphological complexity. Side branch predilation, a procedural step usually avoided, may be required to maintain side branch patency. We investigated the impact of side branch predilation on the immediate results of percutaneous coronary intervention in complex coronary bifurcation lesions. Methods: Between May 2008 and August 2009, 59 patients with single coronary bifurcation lesions with significant involvement of the main and side branches were included in the study. The main exclusion criteria were: involvement of the left main coronary artery, ST-elevation acute myocardial infarction (<72 hours) and in-stent restenosis. Results: Mean age was 61.2 ± 11 years, 25.4% were female and 30.1% had diabetes mellitus. Lesions were most prevalent in the left anterior descending artery/diagonal branch (86.4%). During procedure, 8.5% (5/59) of lesions had unsuccessful side branch predilation, and 4 of these bifurcations were treated with 2 stents. In the multivariate model, side branch stenosis at baseline was the only significant predictor of unsuccessful side branch predilation (odds ratio 1.15, 95% confidence interval 1.01-1.30; P = 0.04), and side branch stenosis > 87.6% was identified as the most accurate cut-off value to predict failure in the ROC curve. Conclusions: Side branch predilation was associated with immediate side branch failure in <10% of cases, and the only significant predictor in the multivariate model was the severity of side branch stenosis (> 85%) at baseline.

Translated title of the contributionImpact of side branch predilation on percutaneous coronary intervention in complex coronary bifurcation lesions
Original languagePortuguese
JournalRevista Brasileira de Cardiologia Invasiva
Volume20
Issue number2
Publication statusPublished - Jun 2012

Keywords

  • Angioplasty
  • Coronary angiography
  • Coronary artery disease
  • Coronary stenosis
  • Drug-eluting stents
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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