Percutaneous intervention for coronary bifurcations-our experience on 133 patients at army cardiac centre Lahore

ABSTRACT

To study the safety and efficacy [pre and post procedure outcomes] of stenting the main vessel [MV] with or without stenting the side branch [SB] in the treatment of coronary bifurcation lesions. In this retrospective analysis of 133 patients, operated between Oct 2009 and Sept 2010, true coronary bifurcation lesions using the registry at Army Cardiac Centre were analyzed. All angiograms and case notes were reviewed for sites of lesions, MADINA classification, angle of bifurcation, size of MV and of SB, number and type of stents used, total procedure and radiation time, and patient characteristics. In-hospital MACE events were recorded for all patients. Of the 133 cases, 120 [90.2%] underwent MV stenting alone, while 13[9.8%] underwent SB stenting as well. Drug Eluting Stent [DES] with minicrash technique was deployed in the majority of the latter cases. In hospital clinical follow up showed 2 NSTEMI in the SB stents [p=0.009] whereas no MACE event was recorded for MV stents alone. Stenting of only MV is safer, effective and economical than stenting of both MV and SB. Moreover contrast related risks and risks of radiation are much less with stenting the MV in the treatment of coronary bifurcation as compared to stenting of both MV and SB