Safety and effectiveness of percutaneous coronary intervention using main branch stenting in combination with side branch drug-coated balloons on coronary bifurcation lesions / 中华老年医学杂志

ABSTRACT

Objective To evaluate the safety and effectiveness of drug-eluting stents (DES)implanted in the main branch(MB)of the coronary artery combined with drug-coated balloon(DCB)inflation in the side branch(SB)in patients with coronary bifurcation lesions.Methods A total of 68 patients with true coronary bifurcation lesions(Medina 1,1,1;1,0,1;0,1,1) admitted into our hospital from June 2017 to June 2018 were enrolled in this single center observation study.Patients were treated with DES MB implantation and DCB SB inflation,and were followed up and assessed with quantitative coronary angiography(CAG)at 6 months after PCI.The primary endpoints were late lumen loss(LLL)of MB and SB at 6 months after PCI.Results DES was implanted in MB in 68 patients.DCB was used in SB in 67 patients,and DES was implanted in SB in 1 patient due to TIMI 1 flow in SB after predilation.The rate of residual stenosis was (8.9 ± 5.6) ％ in MB and (19.7 ± 6.2)％ in SB immediately after PCI.Of 68 patients,type A dissection occurred in 7 cases and type B dissection in 5 cases in MB immediately after PCI.Overall 64 patients were followed up and assessed with quantitative CAG at 6 months after PCI.The LLL of MB was (0.25±0.31)mm and the LLL of SB was-(0.12±0.38)mm.All patients' SB dissection disappeared,and 1 patient died due to cerebral hemorrhage at 2 months after PCI.The 30-day main adverse cardiac events(MACE)was 0,and 6-month MACE was 5.97％,in which 2 cases had angina pectoris at about 3 months after PCI,with CAG showing in-stent restenosis(ISR)in the left anterior descending coronary artery(LAD)and good SB.DCB was used to treat ISR.LAD was good when assessed with CAG at 6 months during follow-up.Myocardial infarction occurred in 2 cases at about 4 months after PCI,but not in the target-vessel.Conclusions DES MB implantation combined with DCB SB inflation is safe and effective in treating coronary bifurcations lesions.