Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―

Seung Hwa Lee, Young Bin Song, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Joo Yong Hahn, Jin Ho Choi, Seung Hyuk Choi, Sang Hoon Lee, Joong Hyun Ahn, Keumhee C. Carriere, Myung Ho Jeong, Hyo Soo Kim, Ju Hyeon Oh, Yangsoo Jang, Hyeon Cheol Gwon

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3 Citations (Scopus)

Abstract

Background: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach. Methods and Results: A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization. SB predilation was performed in 437 (40.4%) patients. Abrupt (10.5% vs. 11.3%; P=0.76) or final SB occlusion (2.7% vs. 3.9%; P=0.41) showed no differences between the predilation and non-predilation groups. The rates of angiographic success (69.1% vs. 52.9%, P<0.001) and SB stent implantation (69.1% vs. 52.9%, P<0.001) were significantly higher in the predilation group. During a median follow-up of 36 months, we found no significant difference between the groups in the rate of MACE (9.4% vs. 11.5%; P=0.67) in a propensity score-matched population. In subgroup analysis, patients with minimal luminal diameter of the parent vessel ≤1 mm benefited from SB predilation in terms of preventing abrupt SB occlusion (P for interaction=0.04). Conclusions: For the treatment of true bifurcation lesions, SB predilation improved acute angiographic and procedural outcomes, but could not improve long-term clinical outcomes. It may benefit patients with severe stenosis in the parent vessel.

Original languageEnglish
Pages (from-to)1293-1301
Number of pages9
JournalCirculation Journal
Volume82
Issue number5
DOIs
Publication statusPublished - 2018

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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