Angioplasty of bifurcation with one stent: The best technique to optimize the result? - 05/01/18
Résumé |
Background |
Bifurcation lesions account for 20% of all angioplasty performed. Several studies have shown that single-stent techniques compared to two-stent techniques offer better long-term results with less risk of restenosis and revascularization. However, there are little data about the best technique for optimizing the outcomes when performing single-stent angioplasty. The aim of the study was to compare the results of kissing, proximal optimization technique (POT), or combining the two techniques.
Methods |
Our study was retrospectively carried out over the period from January 2008 to December 2015 and included all patients who underwent true bifurcation angioplasty using the single-stent provisional technique. We compared the rate of restenosis and major cardiovascular events (MCV) in 3 groups: Group 1=final kissing, group 2=final POT alone and group 3=kissing+POT.
Results |
We included 125 patients with an average age of 61±11 years, a male predominance was noted, 74% of our patients were diabetic and 68% were smokers. Angioplasty was performed in the context of stable coronary disease in 48%. Most of our patients have one vessel disease; the most frequently treated seat was the left anterior descending artery-diagonal bifurcation (72%). Most patients received kissing alone (group 1=82), 21 patients received POT alone and 22 patients were treated with kissing+POT. The MCV rate at 1 month (P=0.52) and 1 year (P=0.06) did not differ between the 3 groups. However, the target lesion revascularization rate was higher in the second group (group 1=12.06%, group 2=19.04% et group 3=13%, P=0.04), this is because of a higher rate of restenosis in the side branch when performing POT.
Conclusion |
Our study asserts that during true bifurcation angioplasties, the POT technique is associated with a higher risk of restenosis of the side branch. Performing a final kissing balloon can reduce this risk.
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Vol 10 - N° 1
P. 14 - janvier 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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