J Korean Med Sci.  2015 Jul;30(7):889-894. 10.3346/jkms.2015.30.7.889.

Comparison of Angiographic Outcomes of Side Branch Ostium at Bifurcation Coronary Lesion between Two-stent and One-stent Techniques

• Seo JB
• Park KW
• Lee HY
• Kang HJ
• Koo BK
• Kim SH
• Kim HS

• KMID: 2164473
• DOI: http://doi.org/10.3346/jkms.2015.30.7.889

Abstract

Although the favored strategy for coronary bifurcation intervention is stenting main vessel with provisional side branch (SB) stenting, we occasionally use two-stent strategy. The objective of this study was to investigate the angiographic outcome of SB ostium in two-stent group, compared with one-stent group. We analyzed 199 patients with bifurcation lesion who underwent percutaneous coronary intervention (PCI) with drug-eluting stent and follow up angiography. The patients were divided into one-stent group (167 lesions, 158 patients) and two-stent group (41 lesions, 41 patients). Prior to intervention, SB ostium minimal luminal diameter (MLD) was smaller in two-stent group than in one-stent group (1.08+/-0.55 mm vs. 1.39+/-0.60 mm; P=0.01). But, immediately after PCI, SB MLD of two-stent group became greater than that of one-stent group (2.41+/-0.40 mm vs. 1.18+/-0.68 mm; P<0.01). Six to nine months after PCI, this angiographic superiority in SB MLD of two-stent group persisted (1.56+/-0.71 mm vs. 1.13+/-0.53 mm; P<0.01), although there was larger late loss in two-stent group (0.85+/-0.74 mm vs. 0.05+/-0.57 mm; P<0.01). In terms of target lesion revascularization and target vessel revascularization rates, one-stent group showed better results than two-stent group. We could attain wider long term SB ostium after two-stent strategy than after one-stent strategy.

Keyword

Bifurcation Lesion; Side Branch; Drug-Eluting Stents

MeSH Terms

Aspirin/therapeutic use
Cohort Studies
*Coronary Angiography
Coronary Vessels/radiography
*Drug-Eluting Stents
Female
Heart/radiography
Heart Septal Defects, Atrial/diagnosis/*radiography
Humans
Male
Middle Aged
Myocardial Revascularization/*methods
Percutaneous Coronary Intervention/*methods
Platelet Aggregation Inhibitors/therapeutic use
Retrospective Studies
Ticlopidine/analogs & derivatives/therapeutic use
Treatment Outcome
Aspirin
Platelet Aggregation Inhibitors
Ticlopidine

Figure

• 

  Fig. 1 Flow diagram of the subject selection. QCA, Quantitative coronary angiography; CAG, Coronary angiography.

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