小血管支架点状置入与雷帕霉素洗脱支架治疗小血管长病变的对照研究

目的 评价小血管支架点状置人与雷帕霉素洗脱支架治疗小血管长病变的近期以及远期疗效。方法 2002年12月至2005年8月接受经皮穿刺冠状动脉介入治疗的小血管、长病变（血管直径〈3．0mm,病变长度〉20mm）患者。根据其治疗策略分为小血管支架点状置入组（SVS组）及雷帕霉素洗脱支架组（SES组）。观察两组术后6个月时支架内再狭窄、靶病变再次血运重建（TLR）以及主要不良心脏事件（MACE）发生率。结果 共有206例患者人选,其中SVS组113例,SES组93例。两组之间基础临床及病变血管特征均无显著差异。SES组有2例病变血管迂曲、钙化,CYPHER支架不能通过,换用DRIVER支架后顺利完成手术。在随访期间SES组支架内再狭窄发生率（4．0％vs26．5％,P〈0．05）,TLR发生率（2．2％vs10．6％,P〈0．05）以及MACE发生率（3．2％vs13．3％,P〈0．05）均明显低于SVS组。结论 对于SES通过困难的小血管、长病变,可选用SVS点状置入。     

冠状动脉植入金属裸支架适应证的研究

背景　目前国内植入金属裸支架（BMS）的比例不足5%,远低于美国和欧洲国家的30%~40%。其原因是对植入BMS适应证研究报道较少,BMS的认识还停留在初级阶段。BMS的适应证、效果和安全性受到质疑。目的　探讨急性冠脉综合征（ACS）患者植入BMS的适应证、长期效果和安全性。方法　选取2001—2010年在北华大学附属医院心脏中心住院植入BMS和药物洗脱支架（DES）随访资料完整的ACS患者1 203例为研究对象,其中BMS组491例和DES组712例。患者均住院行冠状动脉造影（CAG）或门诊行CT血管造影（CTA）随访,随访时间为12~175个月,平均随访（71.4±36.4）个月。比较两组不同病变类型（A、B1、B2、C型病变）患者随访终点事件及再狭窄发生率的差异。结果　BMS组与DES组患者心力衰竭、靶血管重建（TVR）、冠状动脉旁路移植术（CABG）发生率比较,差异均无统计学意义（P>0.05）;BMS组患者全因死亡、总主要不良心血管事件（MACE）、靶病变血管重建（TLR）发生率高于DES组,再发非致命性心肌梗死、支架内血栓形成（ST）发生率低于DES组（P<0.05）。两组A型病变患者全因死亡、总MACE、再发非致命性心肌梗死、心力衰竭、TLR、TVR、ST发生率比较,差异均无统计学意义（P>0.05）。BMS组B1型、B2型、C型病变患者全因死亡、总MACE、TLR发生率高于DES组（P<0.05）。两组A型、B1型病变患者支架内再狭窄、节段内再狭窄、支架内再狭窄和/或节段内再狭窄发生率比较,差异均无统计学意义（P>0.05）。两组B2型、C型病变患者节段内再狭窄发生率比较,差异均无统计学意义（P>0.05）;BMS组B2型、C型病变患者支架内再狭窄、支架内再狭窄和/或节段内再狭窄发生率高于DES组（P<0.05）。结论　A型病变ACS患者植入BMS长期全因死亡、总MACE、TLR发生率和再狭窄发生率与DES无差异,远期效果好,安全性高,故可把A型病变ACS作为植入BMS的适应证。     

雷帕霉素洗脱支架与金属裸支架的临床对照研究

目的评价雷帕霉素洗脱支架预防支架内再狭窄的有效性和安全性。方法入选我院2003年2月至2006年6月首次行经皮冠状动脉介入治疗（PCI），并于植入支架后6～12个月复查冠状动脉造影的患者共54例，83处病变，按有无药物涂层分为雷帕霉素洗脱支架组（SES）31枚，金属裸支架组（BMS）56枚。随访12个月，比较两组间成功率、并发症发生率、心血管事件发生率（MACE）、再狭窄率及晚期管腔丢失等指标。结果两组支架植入术的成功率100％，无残余狭窄，无任何并发症。术后12个月随访结果：SES组与BMS组再狭窄率分别为3．2％和23．2％，晚期管腔丢失分别为（0．02&#177;0．34）mm和（0．80&#177;0．56）mm，靶血管再次血运重建率分别为3．2％和12．5％，心血管不良事件发生率分别为3．2％和14．3％。结论雷帕霉素洗脱支架有较强的安全性、有效性，与金属裸支架相比雷帕霉素洗脱支架明显降低盘榘内再狭窄率和心血管事件发生率。     

紫杉醇洗脱支架在冠状动脉病变介入治疗的远期疗效和安全性

目的 评价紫杉醇洗脱支架治疗冠状动脉病变的远期临床疗效和安全性.方法 118例(共有187处病变)入选本研究的患者随机分为2组,紫杉醇洗脱支架组59例,裸支架对照组59例.结合冠脉造影结果和心电图或者心肌ECT等显像结果确定冠脉靶血管来植入支架,紫杉醇洗脱支架组患者冠脉96处病变,共植入支架96枚,裸支架对照组患者冠脉91处病变,共植入支架91枚.术后患者随访2年,观察心脏主要不良事件(MACE)事件的发生率,复查平板运动试验以及冠状动脉造影.结果 两组基本临床特征相似,支架植入成功率为100%.有95%的患者完成了2年的随访,紫杉醇洗脱支架组总的MACE事件发生率为5.1%(3/59),裸支架对照组为23.7%(13/59),两组比较差异有显著性(P＜0.05);紫杉醇洗脱支架组5.2%(5/96)靶血管发生了支架内再狭窄,裸支架对照组15.4%(14/91)靶血管发生了支架内再狭窄,相比紫杉醇洗脱支架组发生率高(P＜0.05).两组患者在出血事件发生率方面相比差异无显著性(P＞0.05).结论 紫杉醇洗脱支架在预防再狭窄及降低MACE方面有优势,治疗冠状动脉病变安全性与裸支架相同.     

植入金属裸支架治疗急性冠脉综合征患者的长期疗效与安全性随访研究

目的　探讨植入金属裸支架（BMS）治疗急性冠脉综合征（ACS）患者的长期疗效和安全性。方法　选择2000—2005年北华大学附属医院住院植入BMS随访资料完整的ACS患者491例为研究对象,均行经皮冠状动脉介入治疗植入BMS。经住院冠状动脉造影随访、门诊随访或电话随访,记录主要终点事件。结果　平均随访（95±39）个月,随访期间累积171例发生主要心脏不良事件（MACE）,MACE发生率为34.83%,年均MACE发生率为4.38%。死亡68例（13.85%）,靶病变血管重建71例（14.46%）,靶血管重建28例（5.70%）,晚期支架内血栓（LST）和极晚期支架内血栓（VLST）0例,心力衰竭2例（0.41%）,冠状动脉旁路移植2例（0.41%）。发生支架内再狭窄106例（21.59%）,支架节段内再狭窄60例（12.22%）,支架内再狭窄合并支架节段内再狭窄127例（25.87%）。结论　植入BMS治疗ACS患者,远期MACE、LST、VLST发生率较低,安全性较好。     

雷帕霉素洗脱支架在ST段抬高性急性心肌梗死患者PCI中的应用

目的 探讨雷帕霉素洗脱支架(SES)在急性ST段抬高性心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)中的近、远期疗效及安全性.方法 226例确诊为STEMI患者分为金属裸支架(BMS)组(n=98)和SES组(n=128),分别植入BMS和SES,对比观察术后30 d内及30 d～1年两组主要心脏事件(MACE)[心脏性死亡、非致死性心肌梗死、靶血管再次血运重建率(TVR)]的发生率.结果 术后30 d内两组MACE发生率差异无统计学意义(P＞0.05).与BMS组相比,术后30 d～1年SES组MACE发生率显著降低(分别为5.7%和14.9%,P＜0.01),主要与TVR显著降低有关(分别为3.3%和11.7%,P＜0.01);两组间再次非致死性心肌梗死(分别为0.8%和1.1%)及心脏性死亡(分别为1.6%和2.1%)的发生率差异无统计学意义(均P＞0.05).结论 STEMI患者采用SES治疗1年内疗效明显优于BMS,两者安全性相似;长期疗效及安全性还需要进一步临床研究证实.     

在日常临床实践中植入雷帕霉素洗脱支架是安全的

数个随机的临床试验均已证实,与普通裸金属支架（BMS）相比植入雷帕霉素洗脱支架（SES）可在3年内明显减少再狭窄率和靶病变血运重建的几率.RAVEL试验和SIRIUS试验发现,SES的再狭窄率分别为0和8.9%.而在包含了诸多“复杂病变”如小血管、长病变、合并糖尿病的SIRIUS研究中,与BMS组相比较,SES对支架内再狭窄的影响仍然显示了明显的优势（42.3% vs 5.9%）.在上述试验中,支架的安全性也得到肯定.RAVEL试验随访6个月无1例支架血栓.SIRIUS试验仅联合使用阿司匹林和氯吡格雷两个月,但支架血栓的发生率也仅为1.1%,且均发生在术后1个月内.然而,上述试验未包括所有的临床情况,且试验多在经验丰富的大中心进行.那么SES在一些普遍的临床情况,如患者患有多支血管病变、糖尿病、左主干分叉病变、动脉狭窄、桥血管病变等等情况下的表现如何呢？瑞士的Urban等在《循环》杂志上（Circulation,2006,113：1434-1441）上发表了e-Cypher注册研究1年随访结果,显示在日常临床实践中雷帕霉素洗脱支架术非常安全,支架血栓发生率与之前的试验结果相似.     

无保护左主干病变药物洗脱支架植入术后随访研究

目的 通过对植入药物洗脱支架的无保护左主干(LMCA)患者随访分析,讨论无保护LMCA患者行药物支架植入术的安全性及有效性.方法 连续入选在中山医院心导管室成功植入药物支架的无保护左主干(LMCA)的患者100例,随访住院期间和出院后有无再发心绞痛和主要心脏不良事件(MACE),出院6～9个月复查冠脉造影判断其有无支架内再狭窄,并对不同病变部位和手术方式患者的MACE发生率进行分组统计分析.结果 住院期间MACE发生率为1％,术后2年时MACE发生率为22％.术后6个月内心绞痛缓解率80.80％ (80/99),支架内再狭窄发生率为7.89％.术后2年,非远端病变组与远端病变组的靶血管再次血运重建率(6.52％ vs 24.07％,P=0.001)和MACE发生率(8.70％ vs 33.33％,P=0.003)比较,前者均低于后者,其差别有显著性,而两组死亡率(0％ vs 5.56％,P＞0.05)和心肌梗死发生率差异无显著性(2.17％ vs 3.70,P＞0.05).COX多元回归分析显示只有病变部位是MACE的独立预测因素(beta=-1.541,P=0.005).术后2年内,远端病变组单支架术(n=19)和多支架术(n=35)亚组死亡率(5.26％ vs5.71％,P＞0.05)、心肌梗死率(5.26％ vs 2.86％,P＞0.05)、靶血管再次血运重建率(10.53％ vs 31.43％,P＞0.05)、MACE发生率(21.05％ vs 40.00％,P=0.229)均差异无显著性.结论 无保护左主干病变患者选择性的进行PCI安全可行,有良好的近远期效果.左主干远端分叉病变患者的预后较差.     

药物洗脱支架和金属裸支架对冠心病患者近远期疗效比较

目的对比观察药物洗脱支架(DES)和金属裸支架(BMS)治疗冠心病(CHD)患者近远期临床疗效的影响。方法收集我院2005年1月至2007年1月CHD患者305例,随机分为治疗组和对照组,其中治疗组接受DES治疗,对照组接受BMS治疗,于术后1、3、6、9和12个月进行电话或门诊随访,并于12个月做冠状动脉造影,观察不良心脏事件、支架内血栓及再狭窄的发生率,并评价两组不同因素对再狭窄的影响。结果治疗组置入支架成功率为98.7%,而对照组置入支架成功率为100%。在主要临床事件方面,治疗组主要心脏不良事件、支架内狭窄发生率明显低于对照组,二者相比有显著性差异(P<0.01);而近期血栓事件发生率为2.58%,与对照组相比无显著性差异(P>0.05)。亚组分析,治疗组中在弥漫病变、重叠支架、长支架时的再狭窄率小,与对照组相比,具有显著性差异(P<0.01)。结论在经皮冠状动脉介入治疗术支架置入中,DES具有较低的不良心脏事件、近期血栓及再狭窄的发生率,同BMS相比有显著的优势,近远期疗效是安全、可靠的。     

雷帕霉素洗脱支架在急性ST段抬高性心肌梗死患者PCI中的应用

目的探讨雷帕霉素洗脱支架(SES)在STEMI患者PCI中的疗效及安全性。方法2002年10月至2004年12月112例住院患者,男了4例,女38例,平均年龄(63．5±15．2)岁,根据病史、心电图、血清标记物(CK-MB、CTn-I)确诊为ST段抬高性心肌梗死(STEMI),于发病后40-650 min,接受急诊PCI处理梗死相关血管(IRA)并植入裸支架(BMS)或SES,分组对比观察患者术中情况,记录术后主要心脏事件(MACE):心脏性死亡、心绞痛复发、再梗死、靶病变血运重建率(TVR)。结果112例STEMI患者,其中62例植入BMS,50例植入SES,两组患者中PCI即刻IRA开通率(TIMI血流III级),差异无统计学意义(62／66比47／50,P>0．05),术中均无1例死亡,术后随访期MACE发生率BMS组显著高于SES组(11／66比3／50,P<0．01),其中BMS组心脏性死亡率略高于SES组,但差异无统计学意义(3／66比2／50),心绞痛复发率BMS组高于SES组,差异有统计学意义(8／66比1／50, P<0．01),TVR(PCI／CABG),BMS组显著高于SES组(6／66比1／50,P<0．01)。结论STEMI患者应用SES安全有效,即刻靶血管血运重建率与BMS无明显差异,随访期间,MACE发生率显著低于植入BMS的患者,MACE的减少主要与SES减少心绞痛复发、降低靶血管重建率有关,两者间恶性心脏事件的发生率相似。     

钴合金裸支架与雷帕霉素药物涂层支架在冠心病患者应用中的对比研究

目的比较冠状动脉内钴合金裸支架与雷帕霉素药物支架特点、临床应用的安全性和有效性,探讨钴合金裸支架治疗单支冠状动脉病变冠心病患者的安全性和临床疗效。方法分析经选择性冠状动脉造影(CAG)证实为单支病变血管直径狭窄>70%的冠心病患者204例,81例冠状动脉内置入钴合金裸支架;123例冠状动脉内置入雷帕霉素药物涂层支架,观察术后疗效、12个月内主要不良心脏事件(MACE)发生率及再狭窄率。结果两组手术成功率均为100%。两组患者置入支架的成功率、住院期间急性及亚急性血栓形成率及12个月随访MACE发生率、再狭窄率等差异无统计学意义。结论钴合金裸支架可以安全有效的应用于单支冠状动脉病变的治疗。     

Sirolimus-eluting stents for treatment of drug-eluting versus bare-metal stents restenosis: 42-month clinical outcomes from a Chinese single center

Background  Restenosis of bare-metal stents (BMS) and drug-eluting stents (DES) has been increasingly treated with sirolimus-eluting stents (SES), but the long-term outcomes are unknown.

Methods  In our study, 388 consecutive patients (144 DES restenosis and 244 BMS restenosis) with 400 lesions (147 DES restenosis and 253 BMS restenosis) treated with SES were included. The rates of target lesion revascularization (TLR) and major adverse cardiac events (MACE) at 42 months were analyzed.

Results  At the mean follow-up of 42 months, the rates of death (3.5% vs. 3.3%, P=1.000) and myocardial infarction (2.8% vs. 1.2%, P=0.431) in the DES group and BMS group were comparable. Compared with the BMS group, ischemia-driven TLR occurred with a higher frequency in the DES group (18.8% vs.10.7%, P=0.024). This translated into an increased rate of MACE in the DES group (22.2% vs. 14.0%, P=0.034). Stent thrombosis occurred with a similar frequency in both groups (2.8% vs. 1.6%, P=0.475). Multivariate analysis showed that DES restenosis (OR=1.907, 95% CI 1.108–3.285, P=0.020) and smoking (OR=2.069; 95% CI 1.188–3.605; P=0.010) were independent predictors of MACE.

Conclusions  Although SES implantation appears to be safe and effective, it was associated with higher TLR recurrence for DES than BMS restenosis.

     

Firebird and Cypher sirolimus-eluting stents and bare metal stents in treatment of very long coronary lesions

Background As a kind of sirolimus-eluting stent （SES） made in China, Firebird SES is more effective than bare metal stent （BMS） and not inferior to Cypher SES for short coronary lesions in terms of reduction of restenosis and revascularization. However, Firebird SES does not show any benefits in patients with a very long coronary lesion （VLCL）. The present study was undertaken to evaluate the safety and efficacy of Firebird SES for VLCL by comparison of Cypher SES and BMS. Methods In this prospective, nonrandomized and comparative study, eligible patients with de novo coronary lesion （≥ 30 mm） between January 2005 and June 2006 were allocated into Firebird SES group, Cypher SES group or BMS group. They were subjected to an angiographic follow-up of 6 months and a clinical follow-up of 12 months. The primary endpoints constitute the in-stent and in-segment restenosis rates at 6 months. The secondary endpoint was defined as a major adverse cardiovascular event （MACE） that was a 12-month combined endpoint of all-cause deaths, reinfarction or in-stent thrombosis, and target-lesion revascularization. The 12-month in-stent thrombosis was also evaluated to address the safety of Firebird SES implantation exceptionally. Results A total of 468 patients were assessed for eligibility. Of 113 patients who were finally included according to the prior inclusion and exclusion criteria, 39 （41 lesions） were treated with Firebird SES, 37 （39 lesions） with Cypher SES, and 37 （37 lesions） with BMS. There were no significant differences in the baseline characteristics between the three groups; but there were longer lesions, more frequent use of overlapping stent in the Firebird SES group and the Cypher SES group. Angiographic follow-up showed that the rates of binary stenosis were similar between the Firebird SES group and the Cypher SES group （in-segment： 14.6% vs 12.8%, relative risk （RR）1.14, P=0.81; in-stent： 9.8% vs 10.3%, RR 0.95, P=0.94）, and significantly lower than those in the B     

雷帕霉素洗脱支架在冠心病合并2型糖尿病患者中的应用

目的 评估冠心病合并2型糖尿病患者冠状动脉内植入雷帕霉素洗脱支架的临床疗效。方法155例冠心病合并2型糖尿病患者接受冠状动脉内支架术,其中81例植入雷帕霉素洗脱支架（SES组）,74例接受普通金属裸支架（BMS组）,比较两组的临床一般情况、冠脉造影、支架植入术和远期综合心脏事件发生率。结果两组患者冠脉病变特点和支架植入术情况无统计学差异（P〉0．05）,住院期间均无严重并发症发生。平均随访1年中,SES组远期心脏不良事件发生率显著低于BMS组（P〈0．001）。结论冠心病合并2型糖尿病患者植入雷帕霉素洗脱支架安全有效;与普通金属裸支架相比,雷帕霉素洗脱支架能显著降低心脏不良事件发生率。     

Long-term efficacy and safety of drug-eluting stent implantation for patients with multiple coronary chronic total occlusions

Background Data on the efficacy and safety of drug-eluting stent （DES） for treatment of multiple coronary chronic total occlusion （CTO） lesions are scanty. The aim of the present study was to compare the long-term outcomes of DES versus bare metal stent （BMS） implantation for multiple coronary CTO lesions.Methods We analyzed 188 patients who underwent coronary stenting for at least two de novo CTO lesions in our center from November 2000 to November 2006. Among them, 118 patients （62.8%） received DES and 70 patients （37.2%） received BMS implantation after the recanalization for CTO lesions. All patients were followed up for up to 5 years for the occurrence of major adverse cardiac events （MACE）. Long-term survival rates were estimated with the Kaplan-Meier method.Results There were no significant differences in baseline clinical characteristics and procedural success rate between DES group and BMS group. Compared with the BMS group, the DES group showed a significantly higher rate of long CTO （≥15 mm） （62.0% vs. 50.6%, P=0.023）. The number of stents per lesion （1.39±0.71 vs. 1.17±0.66, P=0.007） and the mean length of stents in the DES group were also higher than those in the BMS group （（40.8±11.4） mm vs. （23.4±8.7） mm, P〈0.001）. But the mean diameter of stents in the DES group was smaller than that in the BMS group （（3.1 ±0.2） mm vs. （3.3±0.5） mm, P〈0.001）. Average follow-up time was 4.8±0.7 （1.5-5.0） years in the BMS group and 4.3±0.5 （1.3-5.0） years in the DES group. Both the 5-year cumulative survival rates and the target vessel revascularization （TVR）-free survival rates of the DES group were significantly higher than those in the BMS group （83.1% vs. 72.9%, Log-rank P=0.044; 77.1% vs. 62.9%, Log-rank P=0.009）. The cumulative MACE-free survival rates in the DES group were significantly higher than those in the BMS group （71.2% vs. 51.4%, Log-rank P=0.001）. Multivariable Cox regression analysis demonstrated that DES implantation for multiple CTO lesions could significantly reduce the long-term MACE risk after percutaneous coronary intervention （PCI） （HR. 0.436; 95%C/ 0.327-0.665, P 〈0.001）. Age over 65 years （HR. 2.018; 95%CI1.491-3.127, P〈0.001） and left ventricular ejection fraction 〈50% （HR. 1.494; 95%CI1.125-2.376, P 〈0.001） were identified as the independent predictors of long-term MACE.Conclusion This study demonstrates the long-term （up to 5 years） efficacy and safety of DES for treatment of multiple coronary CTO lesions, and its superiority compared to BMS in reducing the rates of TVR and MACE.     

Drug-eluting stent for the treatment of small coronary lesion: comparison between sirolimus- and paclitaxel-eluting stent

Background  Patients with small coronary lesions are at increased risk for repeat interventions after coronary angioplasty and stenting. The efficacy of drug-eluting stents (DES) has been demonstrated to improve the outcomes of these patients and is a focus of interest. Currently, two platforms of DES are available (sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES)). However, it has less been known that DES, SES vs PES, is superior for the treatment of small coronary lesions.
Methods  In this retrospective study, 87 consecutive patients with 151 lesions underwent implantation of coronary SES (n=68) and PES (n=83). Quantitative coronary angiography (QCA) was performed at the time of stent implantation and subsequently at 8 months post-stenting. Small vessel disease was defined as lesions in vessels with diameter 2.5 mm measured by QCA. Major adverse cardiac events (MACE) including death, thrombosis, nonfatal myocardial infarction and target lesion revascularization (TLR) were compared between the two groups.
Results  Baseline clinical characteristics and angiographic parameters were similar between the two groups. At clinical and angiographic follow-up, overall thrombosis rates were similar in both groups (0 vs 1.2%, P>0.05). The TLR and in-segment restenosis were not significantly different (19.1% vs 25.3%; 10.3% vs 10.8%, P=0.365 and P=0.913 respectively) between the two groups. The in-stent restenosis rate, however, was significantly higher in the PES group (4.4% vs 21.7%; P=0.002). Similarly, the late loss was significantly higher in the PES group ((0.140.38) mm vs (0.490.61) mm; P<0.001).
Conclusions  In this small sample-size, non-randomized study, the data indicated that implantation of SES for the treatment of patients with small coronary lesion showed more favorable results in respect of restenosis compared with PES implantation.

     

Comparison of drug eluting stents with bare metal stents in daily practice for bifurcation lesions in Chinese patients

Background Recently, numerous randomized and controlled trials have demonstrated great advantages of drug eluting stents (DES) with respect to significant reduction of restenosis and recurrence of symptoms and improvement of clinical outcomes after percutaneous coronary intervention (PCI). Little is known about the comparative effects between DES and bare metal stents (BMS) for bifurcation angioplasty in the Chinese population. We compared the inpatient and 7-month follow-up outcomes between DES and BMS for the treatment of bifurcation lesions. Methods From April 2004 to October 2005, 291 Chinese patients [85.9% male, mean age (57.8±10.4) years] underwent DES (387 lesions) and/or BMS (297 lesions) implantation for bifurcation lesions. Clinical and angiographic follow-up was performed at 7 months. Results Compared with BMS group, patients in DES group had significantly lower rates of restenosis at main branch (9.5% vs 28.7%, P < 0.001) or side branch (14.5% vs 37.0%, P < 0.001) and major adverse cardiac events (MACE) (14.0% vs 26.3%, P = 0.000). The occurrence rate of late in-stent thrombosis did not differ between the two groups in both main (0.8% vs 0, P = 0.224) and side branches (1.4% vs 0, P = 0.198). Target lesion revascularization (TLR) was less frequent in DES group for main branch (8.3% vs 21.3%, P < 0.001) and for side branch (7.6% vs 23.5%, P < 0.001). Multivariate regression analysis revealed that total stent length (OR = 1.029, P = 0.01), postprocedural in-stent minimum lumen diameter (OR = 0.476, P = 0.03) and stent type (OR = 3.988, P = 0.0001) were independent predictors of TLR for main branch. Prior history of coronary intervention (OR = 2.424, P = 0.041), angulated lesion (OR = 2.337, P = 0.033), postdilation (OR = 0.267, P = 0.035) and stent type (DES vs BMS, OR = 5.459, P = 0.000) were independent predictors of TLR for side branch. Conclusion The implantation of DES may be associated with greater reduction of restenosis and TLR than BMS in bifurcations angioplasty.