Effect of Wire Jailing at Side Branch in 1-Stent Strategy for Coronary Bifurcation Lesions
- Authors
- Choi, Yeon-Jik; Lee, Seung-Jun; Kim, Byeong-Keuk; Hong, Sung-Jin; Ahn, Chul-Min; Kim, Jung-Sun; Gwon, Hyeon-Cheol; Kim, Hyo-Soo; Chun, Woo Jung; Hur, Seung-Ho; Nam, Chang-Wook; Han, Seung Hwan; Rha, Seung-Woon; Chae, In-Ho; Jeong, Jin-Ok; Heo, Jung Ho; Yoon, Junghan; Lim, Do-Sun; Park, Jong-Seon; Cha, Kwang Soo; Kim, Doo-Il; Lee, Sang Yeub; Chang, Kiyuk; Hwang, Byung-Hee; Choi, So-Yeon; Jeong, Myung Ho; Choi, Ki-Hong; Song, Young-Bin; Hong, Soon-Jun; Doh, Joon-Hyung; Koo, Bon-Kwon; Hong, Myeong-Ki; Jang, Yangsoo
- Issue Date
- 28-Feb-2022
- Publisher
- ELSEVIER SCIENCE INC
- Keywords
- myocardial infarction; percutaneous coronary intervention; drug-eluting stent(s)
- Citation
- JACC-CARDIOVASCULAR INTERVENTIONS, v.15, no.4, pp.443 - 455
- Journal Title
- JACC-CARDIOVASCULAR INTERVENTIONS
- Volume
- 15
- Number
- 4
- Start Page
- 443
- End Page
- 455
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/83926
- DOI
- 10.1016/j.jcin.2021.11.012
- ISSN
- 1936-8798
- Abstract
- OBJECTIVES This study aimed to determine whether side branch (SB) wire jailing before main vessel (MV) stenting could prevent SB occlusion after the 1-stent strategy for bifurcation percutaneous coronary intervention. BACKGROUND The benefits of SB wire jailing in the 1-stent strategy remain unclear. METHODS From the COBIS (Coronary Bifurcation Stenting) III registry, 1,890 patients with bifurcation lesions who underwent the 1-stent strategy using second-generation drug-eluting stents were identified and classified into 2 groups according to the use of SB wire jailing: wire jailing (n = 819) and non-wire jailing (n = 1,071). The incidence of SB oc-clusion (Thrombolysis In Myocardial Infarction flow grade <3) and target lesion failure (cardiac death, myocardial infarction, or target lesion revascularization) was compared. RESULTS The incidence of final SB occlusion was not significantly different between wire jailing (1.8%) vs non-wire jailing (2.9%; P = 0.182). However, wire jailing at the SB was a significant protective factor for SB occlusion after MV stenting on multivariate analysis and was significantly associated with a lower incidence of SB occlusion in patients with significant stenoses ($60%) at the SB (5.1% vs 11.3%; odds ratio: 0.42; 95% CI: 0.19-0.89; P = 0.028) or MV (3.1% vs 6.2%; odds ratio: 0.49; 95% CI: 0.24-0.95; P = 0.039). During follow-up (median 52 months), the incidence of target lesion failure was not significantly different between wire jailing and non-wire jailing (7.6% vs 6.3%; P = 0.343). CONCLUSIONS During bifurcation percutaneous coronary intervention with the 1-stent strategy, wire jailing at the SB was associated with a lower rate of final SB occlusion following MV stenting in patients with severe stenoses at the SB or MV but not with overall bifurcation lesions. Long-term clinical outcomes were comparable between the 2 groups. (J Am Coll Cardiol Intv 2022;15:443-455) (c) 2022 by the American College of Cardiology Foundation.
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