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Assessment of side branch predilation before a provisional T-stent strategy for bifurcation lesions. A randomized trial.

Abstract：

BACKGROUND:A simple approach is the predominant strategy for the percutaneous coronary intervention of bifurcation lesions. Performing side branch (SB) predilation in this context is currently a matter of controversy. In this study, we assess the efficacy of SB predilatation before a provisional T-stent strategy for bifurcation lesions. METHODS:Between February 2009 and November 2012, 372 patients with true bifurcation lesions were randomized to either predilation of the SB (n = 187) or no predilatation (n = 185) before main branch (MB) stent implantation and a subsequent SB provisional stent strategy. RESULTS:There were no significant differences between the patient groups regarding the baseline characteristics. After MB stent implantation, the TIMI flow of the SB was higher in the patients with SB predilation: TIMI flow 0 to 1; 2 (1%) versus 18 (10%), P < .001; and TIMI flow III; 179 (96%) versus 152 (82%), P < .001. Side branch stenting rates were 4% versus 3%, P = not significant. In addition, 60 patients (32%) from the SB predilation group presented SB residual stenosis by visual inspection <50%, and TIMI flow ≥III did not require any additional treatment. The failure rate of SB rewiring, the time of rewiring, the number of wires used, and the incidence of major events were similar in both groups of patients. CONCLUSIONS:Predilation of the SB resulted in improved TIMI flow after MB stenting and less indication to subsequently treat the SB. If rewiring of the SB is required, predilation did not hinder this maneuver.

journal_name

Am Heart J

journal_title

American heart journal

authors

Pan M,Medina A,Romero M,Ojeda S,Martin P,Suarez de Lezo J,Segura J,Mazuelos F,Novoa J,Suarez de Lezo J

doi

10.1016/j.ahj.2014.05.014

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

374-80

issue

3

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(14)00341-X

journal_volume

168

pub_type

杂志文章,多中心研究,随机对照试验

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