| Title: |
Comparison of 2-stenting strategies depending on sequence or technique for bifurcation lesions in the second-generation drug-eluting stent era -analysis from the cobis (coronary bifurcation stenting) iii registry |
| Authors: |
Kang, J; Han, JK; Yang, HM; Park, KW; Kang, HJ; Gwon, HC; Chun, WJ; Hur, SH; Han, SH; Rha, SW; Chae, IH; Jeong, JO; Heo, JH; Yoon, J; Lim, DS; Park, JS; Hong, MK; Doh, JH; Cha, KS; Kim, DI; Lee, SY; Chang, K; Hwang, BH; Choi, SY; Jeong, MH; Song, YB; Choi, KH; Hong, SJ; Nam, CW; Koo, BK; Kim, HS |
| Contributors: |
101511; Choi, SY |
| Publication Year: |
2021 |
| Subject Terms: |
Coronary Artery Disease; Drug-Eluting Stents; Humans; Platelet Aggregation Inhibitors; Registries; Treatment Outcome; 2-stenting technique; Adjunctive pharmacotherapy; Bifurcation; Left main disease |
| Description: |
Background: It has not been determined which specific 2-stenting strategy is the best for bifurcation lesions. Our aim was to investigate the clinical outcomes of various 2-stenting strategies in the era of 2nd-generation drug-eluting stents (2G-DES). Methods and Results: We analyzed 454 patients who finally underwent 2-stenting for a bifurcation lesion, from among 2,648 patients enrolled in the COBIS III registry. The primary outcome was target lesion failure (TLF). Patients were analyzed according to stenting sequence (provisional [main vessel stenting first] vs. systemic [side branch stenting first]) and stenting technique (crush vs. T vs. culotte vs. kissing/V stenting). Overall, 4.4 years' TLF after 2-stenting treatment for bifurcation lesion was excellent: TLF 11.2% and stent thrombosis 1.3%. There was no difference in TLF according to 2-stenting strategy (11.1% vs. 10.5%, P=0.990 for provisional and systemic sequence; 8.6% vs. 14.4% vs. 12.9% vs. 12.2%, P=0.326 for crush, T, culotte, kissing/V technique, respectively). Only left main (LM) disease and a shorter duration of dual antiplatelet therapy (DAPT) were associated with TLF. The distribution of DAPT duration differed between patients with and without TLF, and the time-point of intersection was 2.5 years. Also, the side branch was the most common site of restenosis. Conclusions: The stenting sequence or technique did not affect clinical outcomes, but LM disease and shorter DAPT were associated with TLF, in patients with bifurcation lesions undergoing 2-stenting with 2G-DES. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
J013469843; http://repository.ajou.ac.kr/handle/201003/24033 |
| DOI: |
10.1253/circj.CJ-20-0999 |
| Availability: |
http://repository.ajou.ac.kr/handle/201003/24033; https://doi.org/10.1253/circj.CJ-20-0999 |
| Accession Number: |
edsbas.F24AFBDA |
| Database: |
BASE |