Effect of Stenting Strategy on the Outcome in Patients with Non-Left Main Bifurcation Lesions
Authors
Yongwhan Lim ; Min Chul Kim ; Youngkeun Ahn ; Doo Sun Sim ; Young Joon Hong ; Ju Han Kim ; Myung Ho Jeong ; Hyeon-Cheol Gwon ; Hyo-Soo Kim ; Seung Woon Rha ; Jung Han Yoon ; Yangsoo Jang ; Seung-Jea Tahk ; Ki Bae Seung
Citation
JOURNAL OF CLINICAL MEDICINE, Vol.11(19) : 5658, 2022-10
Bifurcation ; elective two stent ; non-left main bifurcation ; percutaneous coronary intervention ; provisional one-stent
Abstract
Previous studies have not compared outcomes between different percutaneous coronary intervention (PCI) strategies and lesion locations in non-left main (LM) bifurcation lesions. We enrolled 2044 patients from a multicenter registry with an LAD bifurcation lesion (n = 1551) or non-LAD bifurcation lesion (n = 493). The primary outcome was target lesion failure (TLF), a composite of cardiac death, myocardial infarction, and target lesion revascularization (TLR). During a median follow-up period of 38 months, non-LAD bifurcation lesions treated with the two-stent strategy, compared with the one-stent strategy, were associated with more frequent TLF (20.7% vs. 6.3%, p < 0.01), TLR (16.7% vs. 4.7%, p < 0.01), and target vessel revascularization (TVR; 18.2% vs. 6.3%, p < 0.01). There was no significant difference in outcome among LAD bifurcation lesions treated with different PCI strategies. The two-stent strategy was associated with a higher risk of TLF (adjusted HR 4.34, CI 1.93−9.76, p < 0.01), TLR (adjusted HR 4.30, CI 1.64−11.27, p < 0.01), and TVR (adjusted HR 5.07, CI 1.69−9.74, p < 0.01) in the non-LAD bifurcation lesions. The planned one-stent strategy is preferable to the two-stent strategy for the treatment of non-LAD bifurcation lesions.