Abstract
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'.
| Original language | English |
|---|---|
| Pages (from-to) | 1031-1040 |
| Number of pages | 10 |
| Journal | Journal of Korean medical science |
| Volume | 26 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 2011 Aug 1 |
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All Science Journal Classification (ASJC) codes
- Medicine(all)
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Comparing two-stent strategies for bifurcation coronary lesions : which vessel should be stented first, the main vessel or the side branch? / Shin, Dong Ho; Park, Kyung Woo; Koo, Bon Kwon; Oh, Il Young; Seo, Jae Bin; Gwon, Hyeon Cheol; Jeong, Myung Ho; Seong, In Whan; Rha, Seung Woon; Yang, Ju Young; Park, Seung Jung; Yoon, Jung Han; Han, Kyoo Rok; Park, Jong Sun; Hur, Seung Ho; Tahk, Seung Jea; Kim, Hyo Soo.
In: Journal of Korean medical science, Vol. 26, No. 8, 01.08.2011, p. 1031-1040.Research output: Contribution to journal › Article
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 - 2011/8/1
Y1 - 2011/8/1
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 -