JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 2000; 35:1145-1151
© 2000 by the American College of Cardiology Foundation
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Yamashita, T.
Right arrow Articles by Colombo, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Yamashita, T.
Right arrow Articles by Colombo, A.

ARTICLE

Bifurcation lesions: two stents versus one stent—immediate and follow-up results

Takehiro Yamashita, MD, PhD* {dagger}, Takahiro Nishida, MD* {dagger}, Milena G. Adamian, MD* {dagger}, Carlo Briguori, MD* {dagger}, Marco Vaghetti, MD* {dagger}, Nicola Corvaja, MD* {dagger}, Remo Albiero, MD* {dagger}, Leo Finci, MD* {dagger}, Carlo Di Mario, MD, PhD, FACC* {dagger}, Jonathan M. Tobis, MD, FACC* {dagger} and Antonio Colombo, MD, FACC{dagger}

* EMO Centro Cuore Columbus, Milan, Italy
{dagger} Division of Cardiology, University of California, Los Angeles, California, USA

Manuscript received July 21, 1999; revised manuscript received November 9, 1999, accepted December 29, 1999.

Reprint requests and correspondence: Dr. Antonio Colombo, Emo Centro Cuore Columbus, via M. Buonarroti, 48, 20145 Milan, Italy
columbus{at}micronet.it

OBJECTIVES

The purpose of this study was to evaluate two different techniques of stent placement in bifurcation lesions.

BACKGROUND

Although stent placement with dedicated techniques has been suggested to be a useful therapeutic modality for bifurcation lesions, limited information is available if stent placement on the side branch and on the parent branch provides any advantage over a simpler strategy of stenting the parent vessel and balloon angioplasty of the side branch.

METHODS

Between March 1993 and April 1999, we treated a total of 92 patients with bifurcation lesions with two strategies: stenting both vessels (group B, n = 53) or stenting the parent vessel and balloon angioplasty of the side branch (group P, n = 39). Paired angiograms were analyzed by quantitative angiography, and clinical follow-up was obtained.

RESULTS

Stent placement on both branches resulted in a lower residual stenosis (7.4 ± 10.9% vs. 23.4% ± 18.7%, p < 0.001) in the side branch. Acute procedural success was similar in the two groups (group B: 87% vs. Group P: 92%). In-hospital major adverse cardiac events (MACE) occurred only in group B (13% vs. 0%, p < 0.05). At the six-month follow-up, the angiographic restenosis rate (group B: 62% vs. Group P: 48%) and the target lesion revascularization rate (38% vs. 36%, respectively) were similar in the two groups. There was no difference in the incidence of six-month total MACE (51% vs. 38%).

CONCLUSIONS

For the treatment of true bifurcation lesions, a complex strategy of stenting both vessels provided no advantage in terms of procedural success and late outcome versus a simpler strategy of stenting only the parent vessel.

Abbreviations and Acronyms
  CABG = coronary artery bypass grafting
  DCA = directional coronary atherectomy
  MACE = major adverse cardiac events
  MI = myocardial infarction
  MLD = minimum luminal diameter
  NQMI = Non-Q wave myocardial infarction
  QCA = quantitative coronary angiography
  QMI = Q wave myocardial infarction
  TIMI = thrombolysis in myocardial infarction
  TLR = target lesion revascularization




This article has been cited by other articles:


Home page
 ANGIOLOGYHome page
Shaoliang Chen, Junjie Zhang, Fei Ye, Zhongsheng Zhu, Song Lin, Nailiang Tian, Zhizhong Liu, Weiyi Fang, Yundai Chen, Xuewen Sun, et al.
Crush Stenting With Paclitaxel-Eluting or Sirolimus-Eluting Stents for the Treatment of Coronary Bifurcation Lesions
Angiology, August 1, 2008; 59(4): 475 - 483.
[Abstract] [PDF]

Home page
 J Am Coll Cardiol IntvHome page
H. C. Routledge, M.-C. Morice, T. Lefevre, P. Garot, F. De Marco, B. Vaquerizo, and Y. Louvard
2-Year Outcome of Patients Treated for Bifurcation Coronary Disease With Provisional Side Branch T-Stenting Using Drug-Eluting Stents
J. Am. Coll. Cardiol. Intv., August 1, 2008; 1(4): 358 - 365.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll Cardiol IntvHome page
A. Latib and A. Colombo
Bifurcation Disease: What Do We Know, What Should We Do?
J. Am. Coll. Cardiol. Intv., June 1, 2008; 1(3): 218 - 226.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
B.-K. Koo, K.-W. Park, H.-J. Kang, Y.-S. Cho, W.-Y. Chung, T.-J. Youn, I.-H. Chae, D.-J. Choi, S.-J. Tahk, B.-H. Oh, et al.
Physiological evaluation of the provisional side-branch intervention strategy for bifurcation lesions using fractional flow reserve
Eur. Heart J., March 2, 2008; 29(6): 726 - 732.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
J. M. Wilson and J. T. Willerson
Myocardial Revascularization with Percutaneous Devices
Card. Surg. Adult, January 1, 2008; 3(2008): 573 - 598.
[Full Text]

Home page
 J Am Coll CardiolHome page
J. Tobis, B. Azarbal, and L. Slavin
Assessment of Intermediate Severity Coronary Lesions in the Catheterization Laboratory
J. Am. Coll. Cardiol., February 27, 2007; 49(8): 839 - 848.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
T. K. Steigen, M. Maeng, R. Wiseth, A. Erglis, I. Kumsars, I. Narbute, P. Gunnes, J. Mannsverk, O. Meyerdierks, S. Rotevatn, et al.
Randomized Study on Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions: The Nordic Bifurcation Study
Circulation, October 31, 2006; 114(18): 1955 - 1961.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
A. Hoye, I. Iakovou, L. Ge, C. A.G. van Mieghem, A. T.L. Ong, J. Cosgrave, G. M. Sangiorgi, F. Airoldi, M. Montorfano, I. Michev, et al.
Long-Term Outcomes After Stenting of Bifurcation Lesions With the "Crush" Technique: Predictors of an Adverse Outcome
J. Am. Coll. Cardiol., May 16, 2006; 47(10): 1949 - 1958.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
L Ge, I Iakovou, J Cosgrave, P Agostoni, F Airoldi, G M Sangiorgi, I Michev, A Chieffo, M Montorfano, M Carlino, et al.
Treatment of bifurcation lesions with two stents: one year angiographic and clinical follow up of crush versus T stenting
Heart, March 1, 2006; 92(3): 371 - 376.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
P. W. Serruys, M. J.B. Kutryk, and A. T.L. Ong
Coronary-Artery Stents
N. Engl. J. Med., February 2, 2006; 354(5): 483 - 495.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
I. Iakovou, L. Ge, and A. Colombo
Contemporary Stent Treatment of Coronary Bifurcations
J. Am. Coll. Cardiol., October 18, 2005; 46(8): 1446 - 1455.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
T. Lefevre, J. Ormiston, G. Guagliumi, H.-P. Schultheiss, L. Quilliet, B. Reimers, P. Brunel, W. Wijns, H.J. Buettner, F. Hartmann, et al.
The FRONTIER Stent Registry: Safety and Feasibility of a Novel Dedicated Stent for the Treatment of Bifurcation Coronary Artery Lesions
J. Am. Coll. Cardiol., August 16, 2005; 46(4): 592 - 598.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
R. A. Costa, G. S. Mintz, S. G. Carlier, A. J. Lansky, I. Moussa, K. Fujii, H. Takebayashi, T. Yasuda, J. R. Costa Jr, Y. Tsuchiya, et al.
Bifurcation Coronary Lesions Treated With the "Crush" Technique: An Intravascular Ultrasound Analysis
J. Am. Coll. Cardiol., August 16, 2005; 46(4): 599 - 605.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
L. Ge, F. Airoldi, I. Iakovou, J. Cosgrave, I. Michev, G. M. Sangiorgi, M. Montorfano, A. Chieffo, M. Carlino, N. Corvaja, et al.
Clinical and Angiographic Outcome After Implantation of Drug-Eluting Stents in Bifurcation Lesions With the Crush Stent Technique: Importance of Final Kissing Balloon Post-Dilation
J. Am. Coll. Cardiol., August 16, 2005; 46(4): 613 - 620.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
B.-K. Koo, H.-J. Kang, T.-J. Youn, I.-H. Chae, D.-J. Choi, H.-S. Kim, D.-W. Sohn, B.-H. Oh, M.-M. Lee, Y.-B. Park, et al.
Physiologic Assessment of Jailed Side Branch Lesions Using Fractional Flow Reserve
J. Am. Coll. Cardiol., August 16, 2005; 46(4): 633 - 637.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
Y. Louvard, T. Lefevre, and M.-C. Morice
Percutaneous coronary intervention for bifurcation coronary disease
Heart, June 1, 2004; 90(6): 713 - 722.
[Full Text] [PDF]

Home page
 CirculationHome page
A. Colombo, J. W. Moses, M. C. Morice, J. Ludwig, D. R. Holmes Jr, V. Spanos, Y. Louvard, B. Desmedt, C. Di Mario, and M. B. Leon
Randomized Study to Evaluate Sirolimus-Eluting Stents Implanted at Coronary Bifurcation Lesions
Circulation, March 16, 2004; 109(10): 1244 - 1249.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
J. Al Suwaidi, P. B. Berger, and D. R. Holmes Jr
Coronary Artery Stents
JAMA, October 11, 2000; 284(14): 1828 - 1836.
[Abstract] [Full Text] [PDF]


HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2000 by the American College of Cardiology Foundation.