TY - JOUR
T1 - Comparing two-stent strategies for bifurcation coronary lesions
T2 - which vessel should be stented first, the main vessel or the side branch?
AU - Shin, Dong Ho
AU - Park, Kyung Woo
AU - Koo, Bon Kwon
AU - Oh, Il Young
AU - Seo, Jae Bin
AU - Gwon, Hyeon Cheol
AU - Jeong, Myung Ho
AU - Seong, In Whan
AU - Rha, Seung Woon
AU - Yang, Ju Young
AU - Park, Seung Jung
AU - Yoon, Jung Han
AU - Han, Kyoo Rok
AU - Park, Jong Sun
AU - Hur, Seung Ho
AU - Tahk, Seung Jea
AU - Kim, Hyo Soo
PY - 2011/8
Y1 - 2011/8
N2 - This study compared two-stent strategies for treatment of bifurcation lesions by stenting order, 'main across side first (A-family)' vs 'side branch first (S-family). The study population was patients from 16 centers in Korea who underwent drug eluting stent implantation with two-stent strategy (A-family:109, S-family:140 patients). The endpoints were cardiac death, myocardial infarction (MI), stent thrombosis (ST), and target lesion revascularization (TLR) during 3 years. During 440.8 person-years (median 20.2 months), there was 1 cardiac death, 4 MIs (including 2 STs), and 12 TLRs. Cumulative incidence of cardiac death, MI and ST was lower in A-family (0% in A-family vs 4.9% in S-family, P = 0.045). However, TLR rates were not different between the two groups (7.1% vs 6.2%, P = 0.682). Final kissing inflation (FKI) was a predictor of the hard-endpoint (hazard ratio 0.061; 95% CI 0.007-0.547, P = 0.013), but was not a predictor of TLR. The incidence of hard-endpoint of S-family with FKI was comparable to A-family, whereas S-family without FKI showed the poorest prognosis (1.1% vs 15.9%, retrospectively; P = 0.011). In conclusion, 'A-family' seems preferable to 'S-family' if both approaches are feasible. When two-stent strategy is used, every effort should be made to perform FKI, especially in 'S-family'.
AB - This study compared two-stent strategies for treatment of bifurcation lesions by stenting order, 'main across side first (A-family)' vs 'side branch first (S-family). The study population was patients from 16 centers in Korea who underwent drug eluting stent implantation with two-stent strategy (A-family:109, S-family:140 patients). The endpoints were cardiac death, myocardial infarction (MI), stent thrombosis (ST), and target lesion revascularization (TLR) during 3 years. During 440.8 person-years (median 20.2 months), there was 1 cardiac death, 4 MIs (including 2 STs), and 12 TLRs. Cumulative incidence of cardiac death, MI and ST was lower in A-family (0% in A-family vs 4.9% in S-family, P = 0.045). However, TLR rates were not different between the two groups (7.1% vs 6.2%, P = 0.682). Final kissing inflation (FKI) was a predictor of the hard-endpoint (hazard ratio 0.061; 95% CI 0.007-0.547, P = 0.013), but was not a predictor of TLR. The incidence of hard-endpoint of S-family with FKI was comparable to A-family, whereas S-family without FKI showed the poorest prognosis (1.1% vs 15.9%, retrospectively; P = 0.011). In conclusion, 'A-family' seems preferable to 'S-family' if both approaches are feasible. When two-stent strategy is used, every effort should be made to perform FKI, especially in 'S-family'.
UR - http://www.scopus.com/inward/record.url?scp=80052676671&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80052676671&partnerID=8YFLogxK
U2 - 10.3346/jkms.2011.26.8.1031
DO - 10.3346/jkms.2011.26.8.1031
M3 - Article
C2 - 21860553
AN - SCOPUS:80052676671
VL - 26
SP - 1031
EP - 1040
JO - Journal of Korean Medical Science
JF - Journal of Korean Medical Science
SN - 1011-8934
IS - 8
ER -