scholarly journals Improved Outcomes of Combined Main Branch Stenting and Side Branch Drug-Coated Balloon versus Two-Stent Strategy in Patients with Left Main Bifurcation Lesions

2022 ◽  
Vol 2022 ◽  
pp. 1-7
Author(s):  
Hengdao Liu ◽  
Hailong Tao ◽  
Xufei Han ◽  
Yang Lu ◽  
Xiaofei Xue ◽  
...  
Keyword(s):  
Side Branch ◽  
Drug Eluting Stent ◽  
Left Main ◽  
Luminal Diameter ◽  
Late Lumen Loss ◽  
Improved Outcomes ◽  
Drug Eluting ◽  
Minimal Luminal Diameter ◽  
Bifurcation Lesions ◽  
Drug Coated Balloon

Background. Drug-eluting stent (DES) plus drug-coated balloon (DCB) is a safe and effective treatment strategy for coronary artery bifurcation lesions, but there is no report about this strategy being used for left main (LM) bifurcation lesions. We aim to explore the efficacy and safety of DES plus DCB in the treatment of LM bifurcation lesions. Methods. A total of 100 patients diagnosed with LM bifurcation lesions by coronary angiography were retrospectively enrolled at our center from January 2018 to December 2019. They received either a two-stent strategy or a main branch (MB) stenting plus side branch (SB) DCB strategy and were accordingly divided into the 2-DES group and the DES + DCB group. Patients treated with DES + DCB were compared with a cohort of matched patients treated with a 2-DES strategy. Clinical data was collected and quantitative coronary analysis was performed. Results. For immediate postoperative angiography, though the two groups had no differences in the minimal luminal diameter (MLD) and luminal stenosis of MB, the DES + DCB group had significantly lower SB ostial MLD and a higher degree of residual lumen stenosis than the 2-DES group ( P < 0.05 ). At the time of follow-up, the SB ostial MLD of the DES + DCB group was higher than that of the 2-DES group, but lumen stenosis, late lumen loss (LLL), and LLL at the distal end of the left MB were all smaller than those of the 2-DES group ( P s < 0.05 ). Furthermore, the incidence of lumen restenosis and MACE between the two groups had no significance. Conclusion. The combination of DES and DCB is relatively safe and effective for the treatment of LM bifurcation lesions, and this strategy seems to have advantages in reducing LLL at the SB ostium.

scholarly journals TCT-412 Side Branch Intervention for Non-Left Main True Bifurcation Lesions: Pooled Analysis of Korean Multicenter Drug-Eluting Stent Cohort

2018 ◽  
Vol 72 (13) ◽  
pp. B166
Author(s):  
Gyu Chul Oh ◽  
Jeehoon Kang ◽  
Jung-Kyu Han ◽  
Han-Mo Yang ◽  
Kyung Woo (KW) Park ◽  
...  
Keyword(s):  
Pooled Analysis ◽  
Side Branch ◽  
Drug Eluting Stent ◽  
Left Main ◽  
Drug Eluting ◽  
Bifurcation Lesions

scholarly journals Long-term outcomes following drug-eluting stent implantation in unprotected left main bifurcation lesions

2007 ◽  
Vol 120 (7) ◽  
pp. 545-551 ◽  
Author(s):  
Lei GE ◽  
Cosgrave John ◽  
Iakovou Ioannis ◽  
Ju-ying QIAN ◽  
Agostoni Pierfrancesco ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Drug Eluting Stent ◽  
Left Main ◽  
Long Term Outcomes ◽  
Drug Eluting ◽  
Bifurcation Lesions

Relocation of minimal luminal diameter after bare metal and drug-eluting stent implantation: Incidence and impact on angiographic late loss

2007 ◽  
Vol 69 (2) ◽  
pp. 181-188 ◽  
Author(s):  
Marco A. Costa ◽  
Manel Sabaté ◽  
Dominick J. Angiolillo ◽  
Paula Hu ◽  
Pilar Jimenez-Quevedo ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Drug Eluting Stent ◽  
Bare Metal ◽  
Luminal Diameter ◽  
Late Loss ◽  
Drug Eluting ◽  
Minimal Luminal Diameter

scholarly journals Clinical Outcomes of Dialysis Patients Treated with Drug-Eluting Stent for Left Main Distal Bifurcation Lesions

2021 ◽  
Vol 11 (2) ◽  
pp. 99-108
Author(s):  
Yusuke Watanabe ◽  
Satoru Mitomo ◽  
Ozan M. Demir ◽  
Kuan-Liang Liu ◽  
Ying-Chang Tung ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
High Volume ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Drug Eluting Stent ◽  
Left Main ◽  
Cardiac Events ◽  
Drug Eluting ◽  
Bifurcation Lesions ◽  
Target Lesion Failure

<b><i>Aims:</i></b> We assessed clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) distal bifurcation lesions using drug-eluting stents (DES) in hemodialysis (HD) patients compared to non-HD patients. <b><i>Methods and Results:</i></b> We identified 1,858 consecutive patients who underwent PCI for ULMCA distal bifurcation lesions at 4 high-volume centers in Japan, Italy, and Taiwan between January 2005 and December 2015. Of them, 1,416 patients were treated with DES including 113 HD patients and 1,303 non-HD patients. The primary end point was target lesion failure (TLF) defined as a composite of cardiac death, target lesion revascularization (TLR), and myocardial infarction. HD patients were more likely to be younger and have diabetes mellitus, dyslipidemia, peripheral artery disease, lower ejection fraction, and higher EuroSCORE. TLF rate at 3 years was significantly higher in HD group than in non-HD group (adjusted hazard ratio [HR] 2.43 [1.75–3.38], <i>p</i> &#x3c; 0.001). Cardiac mortality and TLR rate were also significantly higher in HD group than in non-HD group (adjusted HR 3.85 [2.34–6.34], <i>p</i> &#x3c; 0.001, and HR 2.10 [1.41–3.14], <i>p</i> &#x3c; 0.001, respectively). <b><i>Conclusions:</i></b> HD was strongly associated with adverse cardiac events after PCI for ULMCA distal bifurcation lesions with DES.

Abstract 12311: Side Branch Angle Influences the Neointimal Coverage of Drug-Eluting Stent in Coronary Bifurcation Lesions: An Optical Coherence Tomography Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Makoto Watanabe ◽  
Shiro Uemura ◽  
Youko Dote ◽  
Yu Sugawara ◽  
Yutaka Goryo ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Side Branch ◽  
Drug Eluting Stent ◽  
Coronary Bifurcation ◽  
Coronary Bifurcation Lesions ◽  
Branch Angle ◽  
Bifurcation Lesion ◽  
Drug Eluting ◽  
Bifurcation Lesions ◽  
Neointimal Coverage

Background: Stent implantation for coronary bifurcation is intrinsically accompanied with inappropriate strut apposition around side branch (SB), which has potential risk for future development of stent thrombosis. Previous experimental studies indicated that side branch angle (SBA) influences the local flow turbulence and wall shear stress. The purpose of this study was to investigate the relation between SBA and the neointimal coverage of drug-eluting stent (DES) which were implanted in coronary bifurcation lesions. Methods: Forty-seven bifurcation lesions treated with DES were evaluated with FD-OCT in 39 patients (mean age; 65.7±13.9 y.o) at follow-up angiography. Each lesions were divided into the bifurcation lesions without kissing balloon technique (KBT) after stent implantation (non-KBT group; 28 lesions) and those with KBT (KBT group; 19 lesions). Neointimal coverage was assessed based on cross-sectional OCT images containing SB at 0.4mm interval, and separately evaluated in terms of jailing struts over the SB ostium (SO) and non-jailing struts attaching to the vessel wall (VW). BA was measured on the longitudinal reconstruction images of FD-OCT before stent implantation. Incidence of uncovered struts and neointimal thickness were measured. Results: In non-KBT group, the percentage of uncovered struts was significantly higher in lesions with SBA≦60°compared with those with SBA>60°at both SO and VW region (56.9±39.8% vs. 25.6±26.8%, p<0.05; 10.6±7.6% vs. 3.3±4.4%, p<0.01, respectively) and significant negative correlation was found between SBA and the percentage uncovered struts at both SO and VW regions (r=–0.55, p<0.01; r=–0.47, p<0.05, respectively). In KBT group, the percentage of uncovered struts was not significant difference between lesions with SBA≦60°and those with SBA>60°at both SO and VW region (36.7±35.3% vs. 36.6±34.8%; 10.9±10.4% vs. 8.6±12.7%, respectively) and no correlation was found between SBA and the percentage of uncovered struts at both SO and VW region. Conclusions: The neointimal coverage of DES was affected by in bifurcation lesion without KBT, but is not affected in bifurcation lesion with KBT. KBT has potential benefit for neointimal coverage of DES at coronary bifurcation lesion with narrow SBA.

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