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5-Year Outcome of Simple Crossover Stenting in Coronary Bifurcation Lesions Compared With Side Branch Openingopen access
- Authors
- Lee, C.H.[Lee, C.H.]; Nam, C.-W.[Nam, C.-W.]; Cho, Y.-K.[Cho, Y.-K.]; Yoon, H.-J.[Yoon, H.-J.]; Kim, K.-B.[Kim, K.-B.]; Gwon, H.-C.[Gwon, H.-C.]; Kim, H.-S.[Kim, H.-S.]; Chun, W.J.[Chun, W.J.]; Han, S.H.[Han, S.H.]; Rha, S.-W.[Rha, S.-W.]; Chae, I.-H.[Chae, I.-H.]; Jeong, J.-O.[Jeong, J.-O.]; Heo, J.H.[Heo, J.H.]; Yoon, J.[Yoon, J.]; Lim, D.-S.[Lim, D.-S.]; Park, J.-S.[Park, J.-S.]; Hong, M.-K.[Hong, M.-K.]; Lee, S.Y.[Lee, S.Y.]; Cha, K.S.[Cha, K.S.]; Kim, D.-I.[Kim, D.-I.]; Bae, J.-W.[Bae, J.-W.]; Chang, K.[Chang, K.]; Hwang, B.-H.[Hwang, B.-H.]; Choi, S.-Y.[Choi, S.-Y.]; Jeong, M.H.[Jeong, M.H.]; Choi, K.H.[Choi, K.H.]; Song, Y.B.[Song, Y.B.]; Hong, S.-J.[Hong, S.-J.]; Doh, J.-H.[Doh, J.-H.]; Koo, B.-K.[Koo, B.-K.]; Hur, S.-H.[Hur, S.-H.]
- Issue Date
- 2021
- Publisher
- Elsevier Inc.
- Keywords
- bifurcation disease; clinical outcome; percutaneous coronary intervention
- Citation
- JACC: Asia, v.1, no.1, pp.53 - 64
- Indexed
- SCOPUS
- Journal Title
- JACC: Asia
- Volume
- 1
- Number
- 1
- Start Page
- 53
- End Page
- 64
- ISSN
- 2772-3747
- Abstract
- Background: The optimal side branch (SB) treatment strategy after simple crossover stenting in bifurcation lesions is still controversial. Objectives: The purpose of this study was to compare the long-term outcomes of a 1-stent strategy with simple crossover alone versus with an additional SB–opening procedure in patients with left main (LM) and non-LM coronary bifurcation lesions. Methods: Patients who underwent percutaneous coronary intervention with a 1-stent strategy for bifurcation lesions including LM were selected from the COBIS (Coronary Bifurcation Stenting) III registry and divided into the simple crossover–alone group and SB-opening group. Clinical outcomes were assessed by the 5-year rate of target lesion failure (a composite of cardiac death, target vessel myocardial infarction, and target lesion repeat revascularization). Results: Among 2,194 patients who underwent the 1-stent strategy, 1,685 (76.8%) patients were treated with simple crossover alone, and 509 (23.2%) patients were treated with an additional SB-opening procedure. Although the baseline SB angiographic disease was more severe in the SB-opening group, the final lumen diameter of the SB was larger. The 5-year observed target lesion failure rate was similar between the 2 groups (7.0% in the simple crossover vs. 6.7% in SB-opening group; hazard ratio: 0.99; 95% confidence interval: 0.66 to 1.48; p = 0.947), even in the subgroup analyses including LM (9.5% vs. 11.3%; p = 0.442) and true bifurcation (5.3% vs. 7.8%; p = 0.362). The results were not changed after an inverse probability of treatment weighting adjustment. There was no difference in the overall and SB-related target lesion revascularization rate in both groups. Conclusions: The long-term clinical outcome of the 1-stent strategy with simple crossover alone for coronary bifurcation lesions was acceptable compared to those of additional SB-opening procedures. (Korean Coronary Bifurcation Stenting [COBIS] Registry III [COBIS III]; NCT03068494) © 2021 The Authors
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