Randomized Study on Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions

Steigen, Terje K.; Mæng, Michael; Wiseth, Rune; Ērglis, Andrejs; Kumsārs, Indulis; Narbute, Inga; Gunnes, Pål; Mannsverk, Jan; Meyerdierks, Oliver; Rotevatn, Svein; Niemelä, Matti; Kervinen, Kari; Jensen, Jan Skov; Galløe, Anders; Nikus, Kjell; Vikman, Saila; Ravkilde, Jan; James, Stefan; Aarøe, Jens; Ylitalo, Antti; Helqvist, Steffen; Sjögren, Iwar; Thayssen, Per; Virtanen, Kari; Puhakka, Mikko; Airaksinen, Juhani; Lassen, Jens Flensted; Thuesen, Leif

doi:10.1161/circulationaha.106.664920

Cited by 664 publications

(502 citation statements)

References 25 publications

Supporting

Mentioning

466

Contrasting

Unclassified

Order By: Relevance

“…These findings are consistent with the results of a recent prospective, randomized study. 18 In conclusion, compared with the 2-DES strategy, if the final kissing balloon could be achieved, the 1-DES strategy may be more efficient and safe.…”

Section: Discussionmentioning

confidence: 91%

Comparative Study of Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions in Daily Practice in Chinese Patients

Gao

Yang

2008

Clinical Cardiology

View full text Add to dashboard Cite

Background: Recently, several randomized and controlled trials have demonstrated great advantages of a drug-eluting stent (DES) with respect to significant reduction in restenosis and recurrence of symptoms, and improvement in clinical outcomes after percutaneous coronary intervention (PCI). Little is known about the comparative effects of the 1-DES plus the kissing balloon technique with the 2-DES for bifurcation angioplasty in a Chinese population. Methods: From April 2004 to June 2006, 566 consecutive Chinese patients underwent DES implantation for true bifurcation lesions, including 346 1-DES with the kissing balloon technique (300 male, 57.7±11.5 y old) and 220 2-DES (183 male, 58.1±10.7 y old) were analyzed. Clinical and angiographic follow-up was performed after 7 mo. Results: The major adverse cardiac event (MACE) rates were higher in the 2-DES group than in the 1-DES group (5.5% versus 2.0%; p=0.032), which was mainly contributed to by acute myocardial infarction (AMI) (4.5% versus 1.4%; p=0.032), rather than death and target lesion revascularization (TLR) (0% versus 0.5%; p=0.389, 1.4% versus 2.7%; p=0.352). Stent thrombosis rates were higher in the 2-DES group than in the 1-DES group (0.6% versus 2.7%; p=0.042), except for 1 late-stent thrombosis in the 2-DES group, and all of them were subacute stent thrombosis (2 in the 1-DES group and 5 in the 2-DES group). The 7 mo angiographic follow-up rate was 36.4%. In the main branch there was no difference in restenosis rate in the 1-DES group compared with the 2-DES group (9.8% versus 11.9%; p=0.652), but in the side branch the restenosis rate was higher in the 1-DES group (33.6% versus 15.5%; p=0.004). However, there was no difference in in-segment late loss between the 2 groups, either in the main or side branch. Conclusion: Compared with the 2-DES strategy, if a final kissing balloon could be achieved, the 1-DES strategy may be more efficient and safe.

show abstract

Section: Discussionmentioning

confidence: 91%

Comparative Study of Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions in Daily Practice in Chinese Patients

Gao

Yang

2008

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…Thus far, six randomised controlled trials (RCT) have compared the use of two stents versus a single-stent approach in the treatment of BL [15][16][17][18][19][20]. The BBC-ONE trial showed a clinical benefit favouring the single-stent technique, which was mainly driven by a reduction in periprocedural MI, of which clinical consequences are still a matter of debate [21,22].…”

Section: Discussionmentioning

confidence: 99%

Six-month clinical outcomes of the Tryton Side Branch Stent for the treatment of bifurcation lesions

et al. 2012

View full text Add to dashboard Cite

Aims Percutaneous coronary intervention (PCI) of a bifurcation lesion (BL) is still associated with poorer clinical outcomes when compared with PCI of a non-BL. Therefore, several dedicated coronary bifurcation stents, such as the Tryton Side Branch Stent™ (Tryton Medical, Durham, NC, USA), were developed to improve clinical outcomes. We investigated 6-month clinical outcomes after placement of a Tryton stent in 91 patients treated for 93 BLs in our centre. Methods and results All consecutive patients who have undergone PCI of a BL treated with the Tryton stent in our centre were included. Outcomes were defined as any death, cardiac death, myocardial infarction (MI), any revascularisation, ischaemia-driven target vessel revascularisation (TVR), ischaemia-driven target lesion revascularisation (TLR), stent thrombosis, and target vessel failure (TVF; composite of cardiac death, MI, and ischaemia-driven TVR). Event rates were estimated using the Kaplan-Meier method. Thirty-eight (42 %) patients with acute coronary syndrome (ACS) were included (16 % ST-segment elevation MI (STEMI)). The 6-month event rates were 5.4 % (death), 4.3 % (cardiac death), 2.2 % (MI), 4.5 % (any revascularisation), 4.5 % (TVR), 4.5 % (TLR) and 9.7 % (TVF). ConclusionIn a real-world all-comers single-centre registry, the use of the Tryton Side Branch Stent was associated with acceptable procedural and promising clinical outcomes at 6 months, including ACS and STEMI patients.

show abstract

“…The optimal technique with drug-eluting stents (DES) is still the subject of considerable debate because relevant randomized studies [1][2][3] are scarce and small scale. Hence, they are not able to provide real statistical value, often provide no clear definitions of the techniques used and often merely compare stent deployment in the main vessel versus the two branches by means of several heterogeneous techniques.…”

Section: Introductionmentioning

confidence: 99%

Classification of coronary artery bifurcation lesions and treatments: Time for a consensus!

Louvard

Thomas

Džavík

et al. 2007

Cathet Cardio Intervent

Self Cite

265

135

View full text Add to dashboard Cite

Background: Percutaneous coronary intervention (PCI) of coronary bifurcation lesions remains a subject of debate. Many studies have been published in this setting. They are often small scale and display methodological flaws and other shortcomings such as inaccurate designation of lesions, heterogeneity, and inadequate description of techniques implemented. Methods: The aim is to propose a consensus established by the European Bifurcation Club (EBC), on the definition and classification of bifurcation lesions and treatments implemented with the purpose of allowing comparisons between techniques in various anatomical and clinical settings. Results: A bifurcation lesion is a coronary artery narrowing occurring adjacent to, and/or involving, the origin of a significant side branch. The simple lesion classification proposed by Medina has been adopted. To analyze the outcomes of different techniques by intention to treat, it is necessary to clearly define which vessel is the distal main branch and which is (are) the side branche(s) and give each branch a distinct name. Each segment of the bifurcation has been named following the same pattern as the Medina classification. The classification of the techniques (MADS: Main, Across, Distal, Side) is based on the manner in which the first stent has been implanted. A visual presentation of PCI techniques and devices used should allow the development of a software describing quickly and accurately the procedure performed. Conclusion: The EBC proposes a new classification of bifurcation lesions and their treatments to permit accurate comparisons of well described techniques in homogeneous lesion groups. '

show abstract

Randomized Study on Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions

Cited by 664 publications

References 25 publications

Comparative Study of Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions in Daily Practice in Chinese Patients

Comparative Study of Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions in Daily Practice in Chinese Patients

Six-month clinical outcomes of the Tryton Side Branch Stent for the treatment of bifurcation lesions

Classification of coronary artery bifurcation lesions and treatments: Time for a consensus!

Contact Info

Product

Resources

About