Results of provisional stenting with a Sirolimus-eluting stent for bifurcation lesion: Multicenter study in Japan

• Published in: Journal of cardiology 2008-04, Vol.51 (2), p.89-94
• Main Authors: Yanagi, Daizaburo, Shirai, Kazuyuki, Takamiya, Yosuke, Fukuda, Yusuke, Kuwano, Takashi, Ike, Amane, Mori, Ken, Kubota, Kazumitsu, Iwata, Atsushi, Fujimi, Kanta, Kawamura, Akira, Nishikawa, Hiroaki, Miller, Nathan, Zhang, Bo, Tsuchiya, Yoshihiro, Urata, Hidenori, Saku, Keijiro
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty, Balloon, Coronary; Bifurcation lesion; Cardiovascular; Coronary Angiography; Coronary artery disease; Coronary heart disease; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - therapy; Drug-eluting stent; Drug-Eluting Stents; Female; Follow-Up Studies; Humans; Japan; Male; Middle Aged; Sirolimus - administration & dosage; Treatment Outcome
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2007.12.002

Summary Background Treatment of bifurcation lesion with a drug-eluting stent (DES) remains problematic. The purpose of this study was to investigate an appropriate treatment strategy for bifurcation lesion with a Sirolimus-eluting stent (SES). Method One-hundred-forty-one patients with 169 bifurcation lesions were treated at three centers in Japan using a Sirolimus-eluting stent. Forty-six lesions (39 patients) were treated on side branches, and provisional stenting was performed in these cases. We evaluated the angiographic results and clinical outcomes with this strategy. Patients with acute myocardial infarction were excluded. Result After a follow-up period of 184 ± 65 days, there were no deaths or myocardial infarction (MI), and only one (2.0%) target lesion revascularization (TLR). The strategies used for side-branch treatment were balloon only (83.7%) and T or Modified T stent (16.3%). The final kissing balloon technique was performed on 53.4% overall. In patients with a 6-month follow-up angiogram who had 25 bifurcation lesions (including 5 LMT bifurcation lesions, 6 LCX-OM lesions, 13 LAD-Dx lesions, and 1 RCA lesion) that were treated with balloon only, the percent diameter stenosis (%DS) of the side branch at follow-up was similar to that after the procedure (47.2 ± 34.4% vs. 46.4 ± 24.1%). Conclusions In the treatment of bifurcation lesions using a SES, the results of provisional stenting for the side branch are acceptable. Percent DS of the side branch remained unchanged over time after PCI.