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Effect of Wire Jailing at Side Branch in 1-Stent Strategy for Coronary Bifurcation Lesions

 Yeon-Jik Choi  ;  Seung-Jun Lee  ;  Byeong-Keuk Kim  ;  Sung-Jin Hong  ;  Chul-Min Ahn  ;  Jung-Sun Kim  ;  Hyeon-Cheol Gwon  ;  Hyo-Soo Kim  ;  Woo Jung Chun  ;  Seung-Ho Hur  ;  Chang-Wook Nam  ;  Seung Hwan Han  ;  Seung-Woon Rha  ;  In-Ho Chae  ;  Jin-Ok Jeong  ;  Jung Ho Heo  ;  Junghan Yoon  ;  Do-Sun Lim  ;  Jong-Seon Park  ;  Kwang Soo Cha  ;  Doo-Il Kim  ;  Sang Yeub Lee  ;  Kiyuk Chang  ;  Byung-Hee Hwang  ;  So-Yeon Choi  ;  Myung Ho Jeong  ;  Ki-Hong Choi  ;  Young-Bin Song  ;  Soon-Jun Hong  ;  Joon-Hyung Doh  ;  Bon-Kwon Koo  ;  Myeong-Ki Hong  ;  Yangsoo Jang 
 JACC-CARDIOVASCULAR INTERVENTIONS, Vol.15(4) : 443-455, 2022-02 
Journal Title
Issue Date
Coronary Angiography / adverse effects ; Coronary Artery Disease* / complications ; Coronary Artery Disease* / diagnostic imaging ; Coronary Artery Disease* / therapy ; Drug-Eluting Stents* / adverse effects ; Humans ; Myocardial Infarction* / etiology ; Percutaneous Coronary Intervention* / adverse effects ; Stents / adverse effects ; Treatment Outcome
drug-eluting stent(s) ; myocardial infarction ; percutaneous coronary intervention
Objectives: This study aimed to determine whether side branch (SB) wire jailing before main vessel (MV) stenting could prevent SB occlusion after the 1-stent strategy for bifurcation percutaneous coronary intervention.

Background: The benefits of SB wire jailing in the 1-stent strategy remain unclear.

Methods: From the COBIS (Coronary Bifurcation Stenting) III registry, 1,890 patients with bifurcation lesions who underwent the 1-stent strategy using second-generation drug-eluting stents were identified and classified into 2 groups according to the use of SB wire jailing: wire jailing (n = 819) and non-wire jailing (n = 1,071). The incidence of SB occlusion (Thrombolysis In Myocardial Infarction flow grade <3) and target lesion failure (cardiac death, myocardial infarction, or target lesion revascularization) was compared.

Results: The incidence of final SB occlusion was not significantly different between wire jailing (1.8%) vs non-wire jailing (2.9%; P = 0.182). However, wire jailing at the SB was a significant protective factor for SB occlusion after MV stenting on multivariate analysis and was significantly associated with a lower incidence of SB occlusion in patients with significant stenoses (≥60%) at the SB (5.1% vs 11.3%; odds ratio: 0.42; 95% CI: 0.19-0.89; P = 0.028) or MV (3.1% vs 6.2%; odds ratio: 0.49; 95% CI: 0.24-0.95; P = 0.039). During follow-up (median 52 months), the incidence of target lesion failure was not significantly different between wire jailing and non-wire jailing (7.6% vs 6.3%; P = 0.343).

Conclusions: During bifurcation percutaneous coronary intervention with the 1-stent strategy, wire jailing at the SB was associated with a lower rate of final SB occlusion following MV stenting in patients with severe stenoses at the SB or MV but not with overall bifurcation lesions. Long-term clinical outcomes were comparable between the 2 groups.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Lee, Seung-Jun(이승준) ORCID logo https://orcid.org/0000-0002-9201-4818
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Yeon-Jik(최연직) ORCID logo https://orcid.org/0000-0003-0720-1449
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
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