Manuel Pan1, Alfonso Medina2, Miguel Romero3, Soledad Ojeda3, Pedro Martin2, Javier Suarez de Lezo3, Jose Segura3, Francisco Mazuelos3, Jose Novoa2, Jose Suarez de Lezo3. 1. Reina Sofia Hospital, Department of Cardiology, University of Córdoba (IMIBIC), Avenida Melendez Pidal 1, Cordoba, Spain. Electronic address: manuelpan@telefonica.net. 2. Dr Negrin Hospital, Department of Cardiology, University of Las Palmas, Las Palmas de Gran Canaria, Spain. 3. Reina Sofia Hospital, Department of Cardiology, University of Córdoba (IMIBIC), Avenida Melendez Pidal 1, Cordoba, Spain.
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.
RCT Entities:
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.
Authors: Michael Bruneau; Sean Walsh; Eric Selinsky; Garrett Ash; Theodore J Angelopoulos; Priscilla Clarkson; Paul Gordon; Niall Moyna; Paul Visich; Robert Zoeller; Paul Thompson; Heather Gordish-Dressman; Eric Hoffman; Joseph Devaney; Linda S Pescatello Journal: Mol Genet Genomic Med Date: 2018-04-06 Impact factor: 2.183
Authors: Indulis Kumsars; Niels Ramsing Holm; Matti Niemelä; Andrejs Erglis; Kari Kervinen; Evald Høj Christiansen; Michael Maeng; Andis Dombrovskis; Vytautas Abraitis; Aleksandras Kibarskis; Thor Trovik; Gustavs Latkovskis; Dace Sondore; Inga Narbute; Christian Juhl Terkelsen; Markku Eskola; Hannu Romppanen; Mika Laine; Lisette Okkels Jensen; Mikko Pietila; Pål Gunnes; Lasse Hebsgaard; Ole Frobert; Fredrik Calais; Juha Hartikainen; Jens Aarøe; Jan Ravkilde; Thomas Engstrøm; Terje K Steigen; Leif Thuesen; Jens F Lassen Journal: Open Heart Date: 2020-01-19
Authors: Francesco Burzotta; Jens Flensted Lassen; Thierry Lefèvre; Adrian P Banning; Yiannis S Chatzizisis; Thomas William Johnson; Miroslaw Ferenc; Sudhir Rathore; Remo Albiero; Manuel Pan; Olivier Darremont; David Hildick-Smith; Alaide Chieffo; Marco Zimarino; Yves Louvard; Goran Stankovic Journal: EuroIntervention Date: 2021-03-19 Impact factor: 6.534