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Long-term clinical outcomes of patients with unprotected left main bifurcation lesions treated with 2-stent techniques / 中华医学杂志(英文版)
Chinese Medical Journal ; (24): 2409-2413, 2013.
Article in English | WPRIM | ID: wpr-322187
ABSTRACT
<p><b>BACKGROUND</b>Currently available evidence suggests that outcomes are less favorable when left main (LM) bifurcation lesions are treated with 2-stent techniques compared with a single-stent technique. We aimed to evaluate the long-term outcomes of the 2-stent techniques for treating unprotected LM bifurcation lesions in Chinese patients.</p><p><b>METHODS</b>We enrolled 301 consecutive patients treated with drug-eluting stents (DES) implantation using 2-stent techniques for unprotected LM bifurcation lesions (MEDINA 1, 1, 1, 70.5%). The 2-stent techniques included crush technique, V stenting, T stenting, and Culottes stenting. After stenting, both vessels were redilated at a high pressure before final kissing balloon (FKB). Clinical and angiographic data were analyzed. The primary endpoints were major adverse cardiac events (MACE), which included death, myocardial infarction, and target lesion revascularization.</p><p><b>RESULTS</b>Immediate procedural success was obtained in all cases with a FKB success rate of 95.3%. Follow-up data were available for all patients. The overall incidence of angiographic in-stent restenosis (ISR) rate was 20.3% and most ISRs were of the focal type. During long-term follow-up (mean duration, (54 ± 22) months), the cumulative incidence of MACE was 11.0%, with 8 (2.7%) deaths, 7 (2.3%) myocardial infarctions, and 18 (6.0%) repeated lesion revascularization. MACEs in high SYNTAX score terciles were significantly higher compared with those in low and intermediate SYNTAX score terciles (P = 0.001).</p><p><b>CONCLUSIONS</b>Although percutaneous coronary intervention (PCI) with 2-stent technique for unprotected LM bifurcation lesions was accompanied with a slightly high incidence of ISR, the long-term clinical follow-up is acceptable. Technical modifications and stent innovations may further improve both the angiographic and clinical outcomes for patients with LM bifurcation disease treated by PCI.</p>
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Therapeutics / Time Factors / Coronary Artery Disease / Epidemiology / Follow-Up Studies / Mortality / Treatment Outcome / Coronary Restenosis / Drug-Eluting Stents / Percutaneous Coronary Intervention Type of study: Observational study / Prognostic study Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Chinese Medical Journal Year: 2013 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Therapeutics / Time Factors / Coronary Artery Disease / Epidemiology / Follow-Up Studies / Mortality / Treatment Outcome / Coronary Restenosis / Drug-Eluting Stents / Percutaneous Coronary Intervention Type of study: Observational study / Prognostic study Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Chinese Medical Journal Year: 2013 Type: Article