Predictors for Side Branch Failure During Provisional Strategy of Coronary Intervention for Bifurcation Lesions (from the Korean Bifurcation Registry) - 10/09/16

Doi : 10.1016/j.amjcard.2016.06.049

Jae-Bin Seo, MD ^a, Dong-Ho Shin, MD ^b, Kyung Woo Park, MD ^c, Bon-Kwon Koo, MD ^c, Hyeon-Cheol Gwon, MD ^d, Myung-Ho Jeong, MD ^e, In-Whan Seong, MD ^f, Seung Woon Rha, MD ^g, Ju-Young Yang, MD ^h, Seung-Jung Park, MD ⁱ, Jung Han Yoon, MD ^j, Kyoo-Rok Han, MD ^k, Jong-Sun Park, MD ^l, Seung-Ho Hur, MD ^m, Seung-Jea Tahk, MD ⁿ, Hyo-Soo Kim, MD, PhD ^c,^⁎
^a Department of Internal Medicine, Boramae Medical Center, Seoul, Korea
^b Department of Internal Medicine, Yonsei University Severance Hospital, Seoul, Korea
^c Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
^d Department of Internal Medicine, Samsung Medical Center, Seoul, Korea
^e Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
^f Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
^g Department of Internal Medicine, Korea University Medical Center, Seoul, Korea
^h Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
ⁱ Department of Internal Medicine, Ulsan University Asan Medical Center, Seoul, Korea
^j Department of Internal Medicine, Wonju Christian Hospital, Wonju, Korea
^k Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
^l Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea
^m Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
ⁿ Department of Internal Medicine, Ajou Univeristy Hospital, Suwon, Korea

^∗Corresponding author: Tel: 82-2-2072-2226; fax: 82-2-766-8904.

Abstract

The most favored strategy for bifurcation lesion is stenting main vessel with provisional side branch (SB) stenting. This study was performed to elucidate predictors for SB failure during this provisional strategy. The study population was patients from 16 centers in Korea who underwent drug-eluting stent implantation for bifurcation lesions with provisional strategy (1,219 patients and 1,236 lesions). On multivariate analysis, the independent predictors for SB jailing after main vessel stenting were SB calcification, large SB reference diameter, severe stenosis of SB, and not taking clopidogrel. Regarding SB compromise, however, the independent predictors were true bifurcation lesion and small SB reference diameter, whereas possible predictors were parent vessel thrombus and parent vessel total occlusion. In addition, SB predilation helps us to get favorable SB outcome. The diameter of SB ostium after main vessel stenting became similar between severe SB lesions treated with predilation and mild SB lesions not treated with predilation. In conclusion, SB calcification, less clopidogrel use, large SB reference diameter, and high SB diameter stenosis are independent predictors for SB jailing, and true bifurcation and small SB reference diameter are independent predictors for SB compromise after main vessel stenting.

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Vol 118 - N° 6

P. 797-803 - septembre 2016 Retour au numéro

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Predictors for Side Branch Failure During Provisional Strategy of Coronary Intervention for Bifurcation Lesions (from the Korean Bifurcation Registry) - 10/09/16

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