Heart India (Jan 2018)
Six months outcome in patients undergoing percutaneous coronary intervention for true bifurcation lesions without side branch stenting
Abstract
Context: Bifurcation lesions is one of the most challenging lesions in interventional cardiology. The optimal management is still a debate. Provisional stenting is preferred approach at present, yet with higher major adverse cardiovascular events (MACE) than other lesions. Aims: The aim of this study is to evaluate outcome in patients with true coronary bifurcation lesion undergoing percutaneous coronary intervention with stenting of the main vessel without side branch (SB) intervention. Design: This was prospective observational study. Subjects and Methods: The study was conducted in patients with stable angina or unstable angina or non ST elevation MI (NSTEMI) attributable to a de novo true coronary bifurcation lesion involving the main vessel and SB. The main vessel diameter has to be ≥≥2.5 mm and the SB has to be ≥≥2.25 mm by visual estimate. Statistical Analysis: Statistical analysis was performed using statistical software package SPSS v22.0. Results: Fifty-three consecutive patients of true bifurcation lesions were studied. They underwent main vessel stenting and were followed up for 6 months. Mean age of 54.9 ± 8.4 was studied, 66% were male, 45.3% were single-vessel disease, left anterior descending (LAD)-diagonal was the most common (43.4%) target bifurcation lesion, most common medina class was 1,1,1 (43.4%). On 6 months follow-up, total MACE events were 12 (22.6%), most were contributed by Target lesion revascularization (TLR) 11 (20.75%). The MACE were significantly associated with diabetes and the extend of coronary artery disease.. Conclusions: Simple stenting strategy in true bifurcation lesions is associated with high MACE events. Further studies dedicated to true coronary bifurcation lesions are required to look for best strategy for these lesions.
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