| Institution: | 1. Division of Cardiology, Asan Medical Center, Seoul, South Korea;2. Chungnam National University Hospital, Daejeon, South Korea;3. Division of Biostatistics, Asan Medical Center, Seoul, South Korea;4. Catholic University of Korea, St. Mary’s Hospital, Seoul, South Korea;6. Cheonan Hospital, Cheonan, South Korea;5. Bucheon Hospital, Bucheon, South Korea;7. Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea;11. Keimyung University Dongsan Medical Center, Daegu, South Korea;12. Yonsei University, Wonju Severance Christial Hospital, Wonju, South Korea;8. National Health Insurance Corporation, Ilsan Hospital, Ilsan, South Korea;10. Soonchunhyang University Hospital, Seoul, South Korea;9. Veterans Hospital, Seoul, South Korea;71. Hallym University Sacred Heart Hospital, Anyang, South Korea |
| Abstract: | ObjectivesThis study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions.BackgroundThe optimal bifurcation stenting technique needs to be evaluated.MethodsThe trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non–left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis.ResultsBetween the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9% versus 9.3% (p = 0.064), comprising 15.1% versus 3.7% for the main branch (p = 0.004) and 2.8% versus 5.6% for the SB (p = 0.50) from 214 patients (69.9%) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0% versus 11.6% between the routine final kissing balloon and leave-alone groups (p = 0.57). In another randomization study for diseased SB lesions, 28.2% in the single-stent group received SB stents. From 300 patients (71.6%) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4% versus 11.0% (p = 0.44), comprising 5.2% versus 4.8% for the main branch (p = 0.90) and 3.9% versus 8.3% for the SB (p = 0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9% versus 18.5% (p = 0.84).ConclusionsAngiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non–left main bifurcation lesions once the procedure was performed successfully. |
