Long-term outcome of simultaneous kissing stenting technique with sirolimus-eluting stent for large bifurcation coronary lesions

Young Hak Kim, Duk Woo Park, Il Woo Suh, Jae Sik Jang, Eui Seock Hwang, Young Hoon Jeong, Se Whan Lee, Seung Whan Lee, Whan Lee Cheol, Myeong Ki Hong, Jae Joong Kim, Seong Wook Park, Seung Jung Park

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Abstract

Objectives: This study was conducted to evaluate the outcomes of simultaneous kissing stenting with sirolimus-eluting stent (SES). Background: Percutaneous intervention for bifurcation coronary lesions is still challenging. Methods: This study was designed to evaluate the long-term outcomes of 36 consecutive patients with large bifurcation coronary lesions who underwent simultaneous kissing stenting with SES. Results: Lesion location was unprotected left main in 29 patients (81%) and anterior descending artery in 7 (19%). The patients received a combination of aspirin and clopidogrel for 6 months and cilostazol for 1 month. Mean proximal reference diameter was 4.05 ± 0.68 mm. Compared with the side branch (SB), the main vessel (MV) involved longer lesions (25.8 ± 17.0 mm vs. 10.2 ± 10.8 mm, P < 0.001) and smaller preprocedural minimal lumen diameters (1.02 ± 0.53 mm vs. 1.46 ± 0.78 mm, P = 0.006) and was treated with larger stents (3.1 ± 0.3 mm vs. 3.0 ± 0.3 mm, P = 0.006). Angiographic success rate was 100%. Over the follow-up of 26.7 ± 8.6 months, no deaths, myocardial infarctions or stent thromboses occurred. Target lesion revascularization was performed in five patients (14%). Overall angiographic restenosis occurred in 5/30 patients (17%), consisting of 4 (13%) at MV and 3 (10%) at SB. At follow-up angiography, a membranous diaphragm at the carina was identified in 14 patients (47%), but only one of whom was associated with angiographic restenosis. Conclusion: Simultaneous kissing stenting with SES appears a feasible stenting technique in large bifurcation coronary lesions. However, a new angiographic structure of carinal membrane developed in a half of patients at follow-up and its influence needs to be further investigated.

Original languageEnglish
Pages (from-to)840-846
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume70
Issue number6
DOIs
Publication statusPublished - 2007 Nov 15

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Kim, Y. H., Park, D. W., Suh, I. W., Jang, J. S., Hwang, E. S., Jeong, Y. H., Lee, S. W., Lee, S. W., Cheol, W. L., Hong, M. K., Kim, J. J., Park, S. W., & Park, S. J. (2007). Long-term outcome of simultaneous kissing stenting technique with sirolimus-eluting stent for large bifurcation coronary lesions. Catheterization and Cardiovascular Interventions, 70(6), 840-846. https://doi.org/10.1002/ccd.21254