open access

Vol 25, No 2 (2018)
Original articles — Interventional cardiology
Published online: 2017-07-14
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Dedicated bifurcation stents or regular drug eluting stents in distal left main stenosis: A retrospective study

Adam Kern, Robert J. Gil, Krystian Bojko, Bartłomiej Rzeszowski, Krzysztof Bednarski, Jerzy Górny, Jacek Bil
DOI: 10.5603/CJ.a2017.0084
·
Pubmed: 28714525
·
Cardiol J 2018;25(2):188-195.

open access

Vol 25, No 2 (2018)
Original articles — Interventional cardiology
Published online: 2017-07-14

Abstract

Background: In the distal left main (LM) atherosclerosis mainly develops within bifurcation or trifur­cation. The aim of this study was to analyze the strategy of distal LM stenosis treatment and associated clinical outcomes in a large hospital in Northern Poland.

Methods: The study population consisted of consecutive patients with stable coronary artery disease or acute coronary syndrome (ACS) and distal LM stenosis who were hospitalized between June 2012 and June 2013. Patients were treated with regular drug-eluting stents (rDES), including bioresorbable vascular scaffolds, or dedicated bifurcation stents (BiOSS LIM®). Clinical outcomes were analyzed at 12, 24 and 36 months. Primary endpoint was cumulative major adverse cardiovascular events (MACE) inducing rate of cardiac death, myocardial infarction, and target lesion revascularization (TLR) after 36 months.

Results: One hundred and two patients were identified, 90 of whom were treated with percutaneous coronary intervention (56 rDES, including 9 Absorb, and 34 BiOSS) with no stent implantation fail­ure. In 15 (16.7%) patients rDES was required within side branch (SB). After 36 months MACE rate was 19.0% (BiOSS: 18.8% vs. rDES 19.2%), whereas TLR rate was 10.7% (BiOSS 12.5% vs. rDES 9.6%). In logistic regression for 36-month TLR rate proximal optimization technique (OR 0.311, 95% CI 0.211–0.644) was a prognostic factor of better clinical outcome, whereas non-ST-elevation ACS (OR 2.211, 95% CI 1.642–5.110), ST-elevation myocardial infarction (OR 2.771, 95% CI 1.325–7.209) and SB stenting (OR 1.141, 95% CI 1.002–1.881) were risk factors of poor outcome.

Conclusions: Regular drug-eluting stents as well as dedicated bifurcation BiOSS LIM® stents enabled a simple and fast distal LM treatment option with a single stent. Both resulted in comparable MACE and TLR rates.

Abstract

Background: In the distal left main (LM) atherosclerosis mainly develops within bifurcation or trifur­cation. The aim of this study was to analyze the strategy of distal LM stenosis treatment and associated clinical outcomes in a large hospital in Northern Poland.

Methods: The study population consisted of consecutive patients with stable coronary artery disease or acute coronary syndrome (ACS) and distal LM stenosis who were hospitalized between June 2012 and June 2013. Patients were treated with regular drug-eluting stents (rDES), including bioresorbable vascular scaffolds, or dedicated bifurcation stents (BiOSS LIM®). Clinical outcomes were analyzed at 12, 24 and 36 months. Primary endpoint was cumulative major adverse cardiovascular events (MACE) inducing rate of cardiac death, myocardial infarction, and target lesion revascularization (TLR) after 36 months.

Results: One hundred and two patients were identified, 90 of whom were treated with percutaneous coronary intervention (56 rDES, including 9 Absorb, and 34 BiOSS) with no stent implantation fail­ure. In 15 (16.7%) patients rDES was required within side branch (SB). After 36 months MACE rate was 19.0% (BiOSS: 18.8% vs. rDES 19.2%), whereas TLR rate was 10.7% (BiOSS 12.5% vs. rDES 9.6%). In logistic regression for 36-month TLR rate proximal optimization technique (OR 0.311, 95% CI 0.211–0.644) was a prognostic factor of better clinical outcome, whereas non-ST-elevation ACS (OR 2.211, 95% CI 1.642–5.110), ST-elevation myocardial infarction (OR 2.771, 95% CI 1.325–7.209) and SB stenting (OR 1.141, 95% CI 1.002–1.881) were risk factors of poor outcome.

Conclusions: Regular drug-eluting stents as well as dedicated bifurcation BiOSS LIM® stents enabled a simple and fast distal LM treatment option with a single stent. Both resulted in comparable MACE and TLR rates.

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Keywords

BiOSS, culotte technique, dedicated bifurcation stent, provisional T-stenting

About this article
Title

Dedicated bifurcation stents or regular drug eluting stents in distal left main stenosis: A retrospective study

Journal

Cardiology Journal

Issue

Vol 25, No 2 (2018)

Pages

188-195

Published online

2017-07-14

DOI

10.5603/CJ.a2017.0084

Pubmed

28714525

Bibliographic record

Cardiol J 2018;25(2):188-195.

Keywords

BiOSS
culotte technique
dedicated bifurcation stent
provisional T-stenting

Authors

Adam Kern
Robert J. Gil
Krystian Bojko
Bartłomiej Rzeszowski
Krzysztof Bednarski
Jerzy Górny
Jacek Bil

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