The clinical outcome of percutaneous treatment of bifurcation lesions in multivessel coronary artery disease with the sirolimus-eluting stent: insights from the Arterial Revascularization Therapies Study part II (ARTS II)

Tsuchida, Kenji; Colombo, Antonio; Lefèvre, Thierry; Oldroyd, Keith G.; Guetta, Victor; Guagliumi, Giulio; Scheidt, Wolfgang von; Rużyłło, Witold; Hamm, Christian W.; Bressers, Marco; Stoll, Hans Peter; Wittebols, Kristel; Donohoe, Dennis; Serruys, Patrick W.

doi:10.1093/eurheartj/ehl539

Cited by 112 publications

(59 citation statements)

References 27 publications

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“…In the Arterial Revascularization Therapies Study part II, there was no difference in any of the endpoints between the true bifurcation group and the non-true bifurcation group. 17 In the present study, we report that patients with true bifurcation lesions had worse long-term clinical outcomes than those with non-true bifurcation lesions. The patients with true bifurcation lesions had a higher prevalence of unfavorable factors, including left ventricular systolic dysfunction, ACS at presentation, 19 and nonuse of IVUS.…”

Section: Study Limitationsmentioning

confidence: 47%

“…1-3 Although some studies have evaluated the value of the angiographic distribution of bifurcation lesions, these have had small sample sizes or contained results with mixed use of bare-metal stents and DES. 16, 17 Therefore, we sought to investigate procedural and long-term clinical outcomes according to angiographic distribution in patients with coronary bifurcation lesions using data from the COBIS II registry. It is well-known that patients with true bifurcation lesions are at higher risk for procedural complications than patients with other types of bifurcation lesions.…”

Section: Study Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification　– Results From the COBIS (COronary BIfurcation Stent) II Registry –

Park

Song

et al. 2015

Circ J

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Section: Study Limitationsmentioning

confidence: 47%

Section: Study Limitationsmentioning

confidence: 99%

Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification　– Results From the COBIS (COronary BIfurcation Stent) II Registry –

Park

Song

et al. 2015

Circ J

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“…12 Regarding SB angulation, Y-shaped angulation constitutes 76.1% and T-shaped angulation 23.9% of lesions. 10 The reverse-shaped angulation is not well studied and hitherto most probably included in the T-shaped angulations.…”

Section: Dino Classification Of Bifurcation Lesionsmentioning

confidence: 96%

A Novel Descriptive, Intelligible and Ordered (DINO) Classification of Coronary Bifurcation Lesions - Review of Current Classifications -

Y‐Hassan

Lindroos

Sylvén

2011

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp oronary artery bifurcation stenosis and some other coronary lesions, such as unprotected left main stem stenosis, multivessel disease and chronic total occlusion, are among the challenging lesions for percutaneous coronary intervention (PCI). 1-5 A proper analysis and classification of both the lesion's localization at the coronary bifurcation site and the side branch (SB) angulation are crucial in individualizing the PCI technique for the treatment of coronary bifurcation stenosis. Several coronary artery bifurcation lesion (CABL) classification systems have been described in the literature. 1,2,6-13 All of them are praiseworthy attempts to simplify a hard topic in interventional cardiology, but nevertheless, they have certain limitations and shortcomings. Not only do the terms used for lesion types not give information about the extent of the lesion's distribution and its localization at site of the bifurcation, they are also difficult to memorize and communicate. Some of the classifications do not cover all categories of bifurcation lesion. Currently, the most commonly applied classification of bifurcation lesions is that proposed by Medina et al, which uses a binary number system for each branch of the bifurcation, but does not consider the bifurcation angle. 11 Herein, we propose the Descriptive, INtelligible and Ordered (DINO), a new verbally anchored, self-descriptive classification system that gives information about the SB angulation relative to the main branch (MB) and about the extent of lesion distribution and its localization. Editorial p 263 Methods and Results The DINO Classification of CABLsDefinitions The coronary artery bifurcation has 3 segments ( Figure 1): 2 from the MB (the proximal MB (PMB) and the distal MB (DMB)) and the 3rd segment is the SB. These 3 branches of the bifurcation form 3 forks: (1) the MB fork formed by the PMB and the DMB; (2) the proximal fork formed by the PMB and the SB; and (3) the distal fork formed by the DMB and the SB. The most important regions of a coronary bifurcation in the setting of coronary angioplasty are the ostial regions (the ostium and the adjacent few Background: Several classification systems for coronary artery bifurcation lesions (CABL) have been described in the literature, but despite the commendable effort to simplify a difficult subject in interventional cardiology, all of them have certain limitations and shortcomings.

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“…The conventional approach to bifurcation PCI (with either single or double stents) still has a number of limitations such as the following [15][16][17][18][19][20] : 1. Maintaining access to SB throughout the procedure.…”

Section: The Rationale For Dedicated Bifurcation Stentsmentioning

confidence: 99%

Dedicated bifurcation stents

Pillai

Jayaraman

2012

Indian Heart Journal

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A B S T R A C TBifurcation percutaneous coronary intervention (PCI) is still a difficult call for the interventionist despite advancements in the instrumentation, technical skill and the imaging modalities. With major cardiac events relate to the side-branch (SB) compromise, the concept and practice of dedicated bifurcation stents seems exciting. Several designs of such dedicated stents are currently undergoing trials. This novel concept and pristine technology offers new hope notwithstanding the fact that we need to go a long way in widespread acceptance and practice of these gadgets. Some of these designs even though looks enterprising, the mere complex delivering technique and the demanding knowledge of the exact coronary anatomy makes their routine use challenging.

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The clinical outcome of percutaneous treatment of bifurcation lesions in multivessel coronary artery disease with the sirolimus-eluting stent: insights from the Arterial Revascularization Therapies Study part II (ARTS II)

Abstract: In this trial without angiographic follow-up, the presence of bifurcations did not affect 1 year outcomes after SES implantation. The outcomes in true vs. partial bifurcations and using one vs. two stents were similar when the treatment strategies were left to the operator's discretion.

Cited by 112 publications

References 27 publications

Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification　– Results From the COBIS (COronary BIfurcation Stent) II Registry –

Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification　– Results From the COBIS (COronary BIfurcation Stent) II Registry –

A Novel Descriptive, Intelligible and Ordered (DINO) Classification of Coronary Bifurcation Lesions - Review of Current Classifications -

Dedicated bifurcation stents

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The clinical outcome of percutaneous treatment of bifurcation lesions in multivessel coronary artery disease with the sirolimus-eluting stent: insights from the Arterial Revascularization Therapies Study part II (ARTS II)

Abstract: In this trial without angiographic follow-up, the presence of bifurcations did not affect 1 year outcomes after SES implantation. The outcomes in true vs. partial bifurcations and using one vs. two stents were similar when the treatment strategies were left to the operator's discretion.

Cited by 112 publications

References 27 publications

Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification – Results From the COBIS (COronary BIfurcation Stent) II Registry –

Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification – Results From the COBIS (COronary BIfurcation Stent) II Registry –

A Novel Descriptive, Intelligible and Ordered (DINO) Classification of Coronary Bifurcation Lesions - Review of Current Classifications -

Dedicated bifurcation stents

Contact Info

Product

Resources

About

Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification　– Results From the COBIS (COronary BIfurcation Stent) II Registry –

Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification　– Results From the COBIS (COronary BIfurcation Stent) II Registry –