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Clinical outcomes following bioresorbable scaffold implantation for bifurcation lesions: Overall outcomes and comparison between provisional and planned double stenting strategy
Authors:Hiroyoshi Kawamoto MD  Azeem Latib MD  Neil Ruparelia DPHIL  MRCP  Tadashi Miyazaki MD  Alessandro Sticchi MD  Toru Naganuma MD  Katsumasa Sato MD  Filippo Figini MD  Alaide Chieffo MD  Mauro Carlino MD  Matteo Montorfano MD  Antonio Colombo MD
Institution:1. Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy;2. Interventional Cardiology Unit, EMO‐GVM Centro Cuore Columbus, Milan, Italy;3. Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan;4. Imperial College, London, United Kingdom;5. Fukuyama Cardiovascular Hospital, Hiroshima, Japan
Abstract:The aim of this study was to investigate clinical outcomes of patients treated with a provisional stenting (PS) versus a double stenting (DS) strategy for coronary bifurcation lesions with bioresorbable scaffolds (BRS). There are limited data available with regards to outcomes following BRS implantation for bifurcation lesions. A total of 132 bifurcation lesions treated with BRS between 2012 and 2014 were analyzed. Of the total of 132 bifurcation lesions, 10 lesions were treated without crossover stenting. 99 lesions (81%) were treated with a PS strategy and 23 lesions (19%) with a DS strategy. The DS group consisted of patients with a greater number of true bifurcation lesions (PS 52.0% vs. DS 91.3%: P < 0.001). In the PS group, seven lesions (7.1%) were crossed‐over to T‐stenting. In the DS group, 13 lesions (57%) were treated with BRS to the side branch (SB). A hybrid stenting technique BRS to the main branch, and metallic drug‐eluting stent (DES) to the SB] was utilized in 10 (43%) lesions. Target lesion revascularization (TLR) rates were 5.5% for PS and 11.2% for DS (P = 0.49) at 1‐year follow‐up. Definite scaffold thrombosis did not occur at the site of any bifurcation lesion. These findings suggest that BRS implantation for bifurcation lesions is technically feasible. The rates of TLR tended to be higher in the DS group compared to when a PS strategy was employed. Larger studies are eagerly awaited to determine longer‐term follow‐up of this treatment strategy. © 2015 Wiley Periodicals, Inc.
Keywords:bioresorbable scaffold  coronary bifurcation  provisional stenting  double stenting
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