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Coronary bifurcation lesions treated with simple or complex stenting: 5-year survival from patient-level pooled analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study ‘Small bifurcation?’ CT myocardial mass volume measurements change therapeutic strategy in coronary artery disease Minimum Core Data Elements for Evaluation of TAVR: A Scientific Statement by PASSION CV, HVC, and TVT Registry Long-term outcomes with use of intravascular ultrasound for the treatment of coronary bifurcation lesions A randomized trial of bifurcation stenting technique in chronic total occlusions percutaneous coronary intervention Percutaneous Coronary Intervention Techniques for Bifurcation Disease: Network Meta-analysis Reveals Superiority of Double-Kissing Crush Diagnostic Accuracy of Computed Tomography-Derived Fractional Flow Reserve : A Systematic Review Influence of the sequence of proximal optimisation technique and side branch dilation for the opening of jailed struts after coronary bifurcation stenting
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Original Research2016 Jun 21;37(24):1923-8.

JOURNAL：Eur Heart J. Article Link

Coronary bifurcation lesions treated with simple or complex stenting: 5-year survival from patient-level pooled analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study

Behan MW, Holm NR, de Belder AJ et al. Keywords: Bifurcation; Coronary; Long-term survival; Stent

ABSTRACT

AIMS - Randomized trials of coronary bifurcation stenting have shown better outcomes from a simple (provisional) strategy rather than a complex (planned two-stent) strategy in terms of short-term efficacy and safety. Here, we report the 5-year all-cause mortality based on pooled patient-level data from two large bifurcation coronary stenting trials with similar methodology: the Nordic Bifurcation Study (NORDIC I) and the British Bifurcation Coronary Study: old, new, and evolving strategies (BBC ONE).


METHODS AND RESULTS - Both multicentre randomized trials compared simple (provisional T-stenting) vs. complex (culotte, crush, and T-stenting) techniques, using drug-eluting stents. We analysed all-cause death at 5 years. Data were collected from phone follow-up, hospital records, and national mortality tracking. Follow-up was complete for 890 out of 913 patients (97%). Both Simple and Complex groups were similar in terms of patient and lesion characteristics. Five-year mortality was lower among patients who underwent a simple strategy rather than a complex strategy [17 patients (3.8%) vs. 31 patients (7.0%); P = 0.04].

CONCLUSION - For coronary bifurcation lesions, a provisional single-stent approach appears to be associated with lower long-term mortality than a systematic dual stenting technique.

TRIAL REGISTRATION - ClinicalTrials.gov NCT00376571 NCT00351260.

Published on behalf of the European Society of Cardiology. All rights reserved.
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