Outcomes at 1 Year of Non-Left Main Trunk Bifurcation Lesions Treated With a 2-Stent Strategy Using Newer-Generation Everolimus-Eluting Stents

Abstract

Study SampleData for 256 consecutive patients (262 lesions) treated at Kurashiki Central Hospital between 2010 and 2018 using the 2-stent strategy with EES for non-LMT bifurcation lesions were assessed retrospectively. The types of EES implanted were the Xience ® (Abbot Vascular, Santa Clara, CA, USA) and the Promus Element TM (Boston Scientific, Natick, MA, USA). Cases of hybrid stenting using both 2-and 3-link EES were excluded. The decision-making process for 2-stent strategies for patients with bifurcation lesions in Kurashiki Central Hospital is as follows: when the main branch has a relatively larger SB (≥2.5 mm in diameter) that exhibits severe stenosis, a longer lesion P ercutaneous coronary intervention (PCI) for coronary bifurcation lesions using the 2-stent strategy remains a challenging procedure for interventionalists because of the higher incidence of in-stent restenosis (ISR) and adverse events. 1-3 However, there are certain situations wherein the 2-stent strategy should be considered, such as the presence of true bifurcation lesions with a side branch (SB) dominating a large area of the myocardium. Previous studies have revealed that the SB ostium was the major site of restenosis that was treated with a 2-stent strategy. 4,5 The major reasons for restenosis at the bifurcation site were suggested to be stent jails of the SB ostium and malapposition of the bifurcation area; 6-8 however, ISR predictors in lesions treated with newer-generation everolimus-eluting stents (EES) remain unknown. Hence, the aim of this study was to evaluate the angiographic and clinical outcomes of non-left main trunk (LMT) bifurcation lesions treated using the 2-stent strategy with newer-generation EES.