Clinical outcome after percutaneous treatment of de novo coronary bifurcation lesions using first or second generation of drug-eluting stents

Ferenc, Mirosław; Buettner, Heinz Joachim; Gick, Michael; Comberg, Thomas; Rothe, Jürgen; Khoury, Firas; Valina, Christian; Toma, Aurel; Kuebler, Piotr; Riede, Florian; Neumann, Franz‐Josef

doi:10.1007/s00392-015-0911-7

Cited by 16 publications

(10 citation statements)

References 26 publications

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“…Several studies have consistently demonstrated that a single-stent provisional strategy of stenting just the main branch (MB) has better clinical outcomes compared to double-stent techniques for bifurcation lesions. However, approximately 35% of patients require crossover to two stent strategy due to compromise of the side branch which often occurs due to plaque or carinal shift 9 . Side branch(SB) rewiring is difficult and time consuming in such cases and can cause prolonged impairment of flow leading to peri procedural MI.…”

Section: Discussionmentioning

confidence: 99%

Balloon embedded bifurcation stenting with single stent for side branch protection – Preliminary results from an Indian population

Vinayakumar

Mohanan

Goyal

2018

Indian Heart Journal

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BackgroundIntervention for bifurcation lesions is associated with increased risk of adverse events and includes acute side branch (SB) occlusion during main branch (MB) stenting. This acute occlusion of side branch can often be catastrophic for the patient. We here in describe our experience in Indian population with a technique which can be incorporated into bifurcation stenting to reduce or almost eliminate the incidence of side branch occlusion.Method and results70 patients with bifurcation lesion were included in the study and underwent a balloon embedded bifurcation stenting with a semi inflated balloon placed across the SB ostium. Angiographic and procedural success were achieved in all the patients. TIMI 3 flow was achieved in both the MB and SB in all cases and there was no incidence of dissection or acute occlusion of SB. Mean fluoroscopy time and contrast volume was similar to that of conventional bifurcation stenting.ConclusionThe present study suggests that balloon embedded bifurcation stenting with a semi inflated balloon to protect the SB is feasible, not associated with procedural adverse events and successful in minimising or almost eliminating the incidence of acute side branch occlusion.

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Section: Discussionmentioning

confidence: 99%

Balloon embedded bifurcation stenting with single stent for side branch protection – Preliminary results from an Indian population

Vinayakumar

Mohanan

Goyal

2018

Indian Heart Journal

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“…This permits much better stent strut apposition to the vessel wall, promoting endothelial healing, and decreasing neointima proliferation, respectively, resulting in less restenosis. Recently, Ferenc et al [24] analysed their results on 2197 patients after stenting coronary bifurcations with different generations of DES. Patients treated with paclitaxel eluting stent (PES) had significantly higher rates of MACE compared with patients treated with sirolimus-eluting stents (SES) or zotarolimus eluting stents (ZES)/everolimus eluting stents (EES): the hazard ratio (HR) (95% CI) of PES vs. SES was 1.34 (1.04-1.71), p = 0.023, and that of PES vs. EES/ZES was 1.75 (1.19-2.57), p = 0.004.…”

Section: What Do the Data Currently Demonstrate About Bifurcationmentioning

confidence: 99%

Is it possible to further improve clinical results with coronary bifurcation stenting, or what is more important — the technique or the stent?

2017

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“…Historically, PCI of bifurcation lesions are known to be associated with poorer procedural success, thus with worse clinical outcomes when compared with PCI of nonbifurcation lesions. 3,4 Extensive debate on the best approach for bifurcation percutaneous treatment is still ongoing. 3,[5][6][7][8] Multiple trials have tested mostly the approach of a provisional stent techniques versus the upfront treatment with two stents.…”

Section: Introductionmentioning

confidence: 99%

Two years clinical outcomes with the state‐of‐the‐art PCI for the treatment of bifurcation lesions: A sub‐analysis of the SYNTAX II study

Modolo

Kogame

Komiyama

et al. 2019

Cathet Cardio Intervent

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Background: Bifurcation PCI is associated with a lower rate of procedural success, especially in multivessel disease patients. We aimed to determine the impact of bifurcation treatment on 2-years clinical outcomes when a state-of-the-art PCI strategy (heart team decision-making using the SYNTAX score II, physiology guided coronary stenosis assessment, thin strut bioresorbable polymer drug-eluting stent, and intravascular ultrasound guidance) is followed.Methods: Three-vessel disease patients enrolled in the SYNTAX II trial (n = 454) were categorized in patients with (a) ≥1 treated bifurcation (n = 126), and (b) without bifurcation (n = 281). The primary endpoint was the occurrence of major adverse cardio and cerebrovascular events (MACCE-a composite of all-cause death, stroke, any myocardial infarction, or any revascularization) at 2 years. Secondary endpoints were the occurrence of target lesion failure (TLF) defined as cardiac death, target-vessel myocardial infarction and ischemia-driven target lesion revascularization, and the individual components of the composite primary endpoint, as well as stent thrombosis.Results: A total of 145 bifurcation were treated in 126 patients. At 2 years, MACCE occurred in 75/407 patients (20.7% for bifurcation versus 17.5% for nonbifurcation, hazard ratio [HR] of 1.28, CI95% 0.78-2.08, p = .32). TLF presented a trend toward higher occurrence in bifurcation (16.

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Clinical outcome after percutaneous treatment of de novo coronary bifurcation lesions using first or second generation of drug-eluting stents

Abstract: In de novo coronary bifurcation lesions treated with provisional T-stenting, SES and EES/ZES achieved better outcomes than PES by reducing the need for reintervention.

Cited by 16 publications

References 26 publications

Balloon embedded bifurcation stenting with single stent for side branch protection – Preliminary results from an Indian population

Balloon embedded bifurcation stenting with single stent for side branch protection – Preliminary results from an Indian population

Is it possible to further improve clinical results with coronary bifurcation stenting, or what is more important — the technique or the stent?

Two years clinical outcomes with the state‐of‐the‐art PCI for the treatment of bifurcation lesions: A sub‐analysis of the SYNTAX II study

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