Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis

Young Hak Kim, Jae Hwan Lee, Jae Hyung Roh, Jung Min Ahn, Sung Han Yoon, Duk Woo Park, Jong Young Lee, Sung Cheol Yun, Soo Jin Kang, Seung Whan Lee, Cheol Whan Lee, Ki Bae Seung, Won Yong Shin, Nae Hee Lee, Bong Ki Lee, Sang Gon Lee, Chang Wook Nam, Junghan Yoon, Joo Young Yang, Min Su HyonKeun Lee, Jae Sik Jang, Hyun Sook Kim, Seong Wook Park, Seung Jung Park

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objectives This study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions. Background The optimal bifurcation stenting technique needs to be evaluated. Methods The trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non-left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis. Results Between the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9% versus 9.3% (p = 0.064), comprising 15.1% versus 3.7% for the main branch (p = 0.004) and 2.8% versus 5.6% for the SB (p = 0.50) from 214 patients (69.9%) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0% versus 11.6% between the routine final kissing balloon and leave-alone groups (p = 0.57). In another randomization study for diseased SB lesions, 28.2% in the single-stent group received SB stents. From 300 patients (71.6%) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4% versus 11.0% (p = 0.44), comprising 5.2% versus 4.8% for the main branch (p = 0.90) and 3.9% versus 8.3% for the SB (p = 0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9% versus 18.5% (p = 0.84). Conclusions Angiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non-left main bifurcation lesions once the procedure was performed successfully.

Original languageEnglish
Pages (from-to)550-560
Number of pages11
JournalJACC: Cardiovascular Interventions
Volume8
Issue number4
DOIs
Publication statusPublished - 2015 Apr 20

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Stents
Pathologic Constriction
Random Allocation
Drug-Eluting Stents
Percutaneous Coronary Intervention
Myocardial Infarction
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Young Hak ; Lee, Jae Hwan ; Roh, Jae Hyung ; Ahn, Jung Min ; Yoon, Sung Han ; Park, Duk Woo ; Lee, Jong Young ; Yun, Sung Cheol ; Kang, Soo Jin ; Lee, Seung Whan ; Lee, Cheol Whan ; Seung, Ki Bae ; Shin, Won Yong ; Lee, Nae Hee ; Lee, Bong Ki ; Lee, Sang Gon ; Nam, Chang Wook ; Yoon, Junghan ; Yang, Joo Young ; Hyon, Min Su ; Lee, Keun ; Jang, Jae Sik ; Kim, Hyun Sook ; Park, Seong Wook ; Park, Seung Jung. / Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis. In: JACC: Cardiovascular Interventions. 2015 ; Vol. 8, No. 4. pp. 550-560.
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title = "Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis",
abstract = "Objectives This study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions. Background The optimal bifurcation stenting technique needs to be evaluated. Methods The trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non-left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis. Results Between the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9{\%} versus 9.3{\%} (p = 0.064), comprising 15.1{\%} versus 3.7{\%} for the main branch (p = 0.004) and 2.8{\%} versus 5.6{\%} for the SB (p = 0.50) from 214 patients (69.9{\%}) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0{\%} versus 11.6{\%} between the routine final kissing balloon and leave-alone groups (p = 0.57). In another randomization study for diseased SB lesions, 28.2{\%} in the single-stent group received SB stents. From 300 patients (71.6{\%}) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4{\%} versus 11.0{\%} (p = 0.44), comprising 5.2{\%} versus 4.8{\%} for the main branch (p = 0.90) and 3.9{\%} versus 8.3{\%} for the SB (p = 0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9{\%} versus 18.5{\%} (p = 0.84). Conclusions Angiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non-left main bifurcation lesions once the procedure was performed successfully.",
author = "Kim, {Young Hak} and Lee, {Jae Hwan} and Roh, {Jae Hyung} and Ahn, {Jung Min} and Yoon, {Sung Han} and Park, {Duk Woo} and Lee, {Jong Young} and Yun, {Sung Cheol} and Kang, {Soo Jin} and Lee, {Seung Whan} and Lee, {Cheol Whan} and Seung, {Ki Bae} and Shin, {Won Yong} and Lee, {Nae Hee} and Lee, {Bong Ki} and Lee, {Sang Gon} and Nam, {Chang Wook} and Junghan Yoon and Yang, {Joo Young} and Hyon, {Min Su} and Keun Lee and Jang, {Jae Sik} and Kim, {Hyun Sook} and Park, {Seong Wook} and Park, {Seung Jung}",
year = "2015",
month = "4",
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doi = "10.1016/j.jcin.2015.01.016",
language = "English",
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pages = "550--560",
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Kim, YH, Lee, JH, Roh, JH, Ahn, JM, Yoon, SH, Park, DW, Lee, JY, Yun, SC, Kang, SJ, Lee, SW, Lee, CW, Seung, KB, Shin, WY, Lee, NH, Lee, BK, Lee, SG, Nam, CW, Yoon, J, Yang, JY, Hyon, MS, Lee, K, Jang, JS, Kim, HS, Park, SW & Park, SJ 2015, 'Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis', JACC: Cardiovascular Interventions, vol. 8, no. 4, pp. 550-560. https://doi.org/10.1016/j.jcin.2015.01.016

Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis. / Kim, Young Hak; Lee, Jae Hwan; Roh, Jae Hyung; Ahn, Jung Min; Yoon, Sung Han; Park, Duk Woo; Lee, Jong Young; Yun, Sung Cheol; Kang, Soo Jin; Lee, Seung Whan; Lee, Cheol Whan; Seung, Ki Bae; Shin, Won Yong; Lee, Nae Hee; Lee, Bong Ki; Lee, Sang Gon; Nam, Chang Wook; Yoon, Junghan; Yang, Joo Young; Hyon, Min Su; Lee, Keun; Jang, Jae Sik; Kim, Hyun Sook; Park, Seong Wook; Park, Seung Jung.

In: JACC: Cardiovascular Interventions, Vol. 8, No. 4, 20.04.2015, p. 550-560.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis

AU - Kim, Young Hak

AU - Lee, Jae Hwan

AU - Roh, Jae Hyung

AU - Ahn, Jung Min

AU - Yoon, Sung Han

AU - Park, Duk Woo

AU - Lee, Jong Young

AU - Yun, Sung Cheol

AU - Kang, Soo Jin

AU - Lee, Seung Whan

AU - Lee, Cheol Whan

AU - Seung, Ki Bae

AU - Shin, Won Yong

AU - Lee, Nae Hee

AU - Lee, Bong Ki

AU - Lee, Sang Gon

AU - Nam, Chang Wook

AU - Yoon, Junghan

AU - Yang, Joo Young

AU - Hyon, Min Su

AU - Lee, Keun

AU - Jang, Jae Sik

AU - Kim, Hyun Sook

AU - Park, Seong Wook

AU - Park, Seung Jung

PY - 2015/4/20

Y1 - 2015/4/20

N2 - Objectives This study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions. Background The optimal bifurcation stenting technique needs to be evaluated. Methods The trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non-left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis. Results Between the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9% versus 9.3% (p = 0.064), comprising 15.1% versus 3.7% for the main branch (p = 0.004) and 2.8% versus 5.6% for the SB (p = 0.50) from 214 patients (69.9%) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0% versus 11.6% between the routine final kissing balloon and leave-alone groups (p = 0.57). In another randomization study for diseased SB lesions, 28.2% in the single-stent group received SB stents. From 300 patients (71.6%) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4% versus 11.0% (p = 0.44), comprising 5.2% versus 4.8% for the main branch (p = 0.90) and 3.9% versus 8.3% for the SB (p = 0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9% versus 18.5% (p = 0.84). Conclusions Angiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non-left main bifurcation lesions once the procedure was performed successfully.

AB - Objectives This study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions. Background The optimal bifurcation stenting technique needs to be evaluated. Methods The trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non-left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis. Results Between the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9% versus 9.3% (p = 0.064), comprising 15.1% versus 3.7% for the main branch (p = 0.004) and 2.8% versus 5.6% for the SB (p = 0.50) from 214 patients (69.9%) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0% versus 11.6% between the routine final kissing balloon and leave-alone groups (p = 0.57). In another randomization study for diseased SB lesions, 28.2% in the single-stent group received SB stents. From 300 patients (71.6%) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4% versus 11.0% (p = 0.44), comprising 5.2% versus 4.8% for the main branch (p = 0.90) and 3.9% versus 8.3% for the SB (p = 0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9% versus 18.5% (p = 0.84). Conclusions Angiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non-left main bifurcation lesions once the procedure was performed successfully.

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