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Bifurcation Stenting

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‘Small bifurcation?’ CT myocardial mass volume measurements change therapeutic strategy in coronary artery disease Influence of the sequence of proximal optimisation technique and side branch dilation for the opening of jailed struts after coronary bifurcation stenting Comparison of intravascular ultrasound-guided with angiography-guided double kissing crush stenting for patients with complex coronary bifurcation lesions: rationale and design of a prospective, randomized and multicenter DKCRUSH VIII trial A randomized trial of bifurcation stenting technique in chronic total occlusions percutaneous coronary intervention Streamlined reverse wire technique for the treatment of complex bifurcated lesions European Bifurcation Club White Paper on Stenting Techniques for Patients With Bifurcated Coronary Artery Lesions One Versus 2-stent Strategy for the Treatment of Bifurcation Lesions in the Context of a Coronary Chronic Total Occlusion:A Multicenter Registry Technical aspects of the culotte technique Randomized study of the crush technique versus provisional side-branch stenting in true coronary bifurcations: the CACTUS (Coronary Bifurcations: Application of the Crushing Technique Using Sirolimus-Eluting Stents) Study Developing a Mobile Application for Global Cardiovascular Education
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Clinical Trial2015 Dec;11(8):856-9.

JOURNAL：EuroIntervention. Article Link

Long-term outcomes of routine versus provisional T-stenting for de novo coronary bifurcation lesions: five-year results of the Bifurcations Bad Krozingen I study

Ferenc M, Ayoub M, Büttner HJ et al. Keywords: bifurcation stenting; routine T-stenting; provisional T-stenting; outcome

ABSTRACT

AIMS - Previously, we reported that the nine-month angiographic result after treatment of coronary bifurcation lesions with provisional T-stenting was not significantly different from that with routine T-stenting. To compare long-term clinical outcomes of the two stenting strategies, we extended the follow-up of our study on bifurcation stenting.

 

METHODS AND RESULTS - One hundred and one patients with coronary bifurcation lesions had been randomly assigned to provisional T-stenting and 101 to routine T-stenting, using sirolimus-eluting stents. We performed complete five-year follow-up. The primary efficacy endpoint was the incidence of target lesion revascularisation (TLR), and the primary safety endpoint was the incidence of definite/probable stent thrombosis (ST). We also monitored death, myocardial infarction (MI) and MACE (composite of death, MI and TLR). The cumulative five-year incidence of TLR in the provisional T-stenting arm was not significantly different from that in the routine T-stenting arm (16.2% vs. 16.3%, p=0.97). The same was true for MACE (22.8% vs. 22.9%, p=0.91), the composite of death and MI (9.9% vs. 13.9%, p=0.40), and ST (2.0% vs. 5.1%; p=0.25).

 

CONCLUSIONS - During five-year follow-up, routine T-stenting offered no advantage over provisional T-stenting with respect to TLR or MACE. ClinicalTrials.gov Identifier: NCT00288535

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