Comparing Two-Stent Strategies for Bifurcation Coronary Lesions: Which Vessel Should be Stented First, the Main Vessel or the Side Branch?open access
- Authors
- Shin, DH[Shin, Dong-Ho]; Park, KW[Park, Kyung Woo]; Koo, BK[Koo, Bon-Kwon]; Oh, IY[Oh, Il-Young]; Seo, JB[Seo, Jae-Bin]; Gwon, HC[Gwon, Hyeon-Cheol]; Jeong, MH[Jeong, Myung-Ho]; Seong, IW[Seong, In-Whan]; Rha, SW[Rha, Seung Woon]; Yang, JY[Yang, Ju-Young]; Park, SJ[Park, Seung-Jung]; Yoon, JH[Yoon, Jung Han]; Han, KR[Han, Kyoo-Rok]; Park, JS[Park, Jong-Sun]; Hur, SH[Hur, Seung-Ho]; Tahk, SJ[Tahk, Seung-Jea]; Kim, HS[Kim, Hyo-Soo]
- Issue Date
- Aug-2011
- Citation
- JOURNAL OF KOREAN MEDICAL SCIENCE, v.26, no.8, pp.1031 - 1040
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- JOURNAL OF KOREAN MEDICAL SCIENCE
- Volume
- 26
- Number
- 8
- Start Page
- 1031
- End Page
- 1040
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/69304
- DOI
- 10.3346/jkms.2011.26.8.1031
- ISSN
- 1011-8934
- Abstract
- This study compared two-stent strategies for treatment of bifurcation lesions by stenting order, 'main across side first (A-family)' vs 'side branch first (S-family). The study population was patients from 16 centers in Korea who underwent drug eluting stent implantation with two-stent strategy (A-family: 109, S-family: 140 patients). The endpoints were cardiac death, myocardial infarction (MI), stent thrombosis (ST), and target lesion revascularization (TLR) during 3 years. During 440.8 person-years (median 20.2 months), there was 1 cardiac death, 4 MIs (including 2 STs), and 12 TLRs. Cumulative incidence of cardiac death, MI and ST was lower in A-family (0% in A-family vs 4.9% in S-family, P = 0.045). However, TLR rates were not different between the two groups (7.1% vs 6.2%, P = 0.682). Final kissing inflation (FKI) was a predictor of the hard-endpoint (hazard ratio 0.061; 95% CI 0.007-0.547, P = 0.013), but was not a predictor of TLR. The incidence of hard-endpoint of S-family with FKI was comparable to A-family, whereas S-family without FKI showed the poorest prognosis (1.1% vs 15.9%, retrospectively; P = 0.011). In conclusion, 'A-family' seems preferable to 'S-family' if both approaches are feasible. When two-stent strategy is used, every effort should be made to perform FKI, especially in 'S-family'.
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