Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―

Seung Hwa Lee; Young Bin Song; Joo Myung Lee; Taek Kyu Park; Jeong Hoon Yang; Joo Yong Hahn; Jin Ho Choi; Seung Hyuk Choi; Sang Hoon Lee; Joong Hyun Ahn; Keumhee C. Carriere; Myung Ho Jeong; Hyo Soo Kim; Ju Hyeon Oh; Yangsoo Jang; Hyeon Cheol Gwon

doi:10.1253/circj.CJ-17-0921

Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―

Seung Hwa Lee, Young Bin Song, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Joo Yong Hahn, Jin Ho Choi, Seung Hyuk Choi, Sang Hoon Lee, Joong Hyun Ahn, Keumhee C. Carriere, Myung Ho Jeong, Hyo Soo Kim, Ju Hyeon Oh, Yangsoo Jang, Hyeon Cheol Gwon

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

Background: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach. Methods and Results: A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization. SB predilation was performed in 437 (40.4%) patients. Abrupt (10.5% vs. 11.3%; P=0.76) or final SB occlusion (2.7% vs. 3.9%; P=0.41) showed no differences between the predilation and non-predilation groups. The rates of angiographic success (69.1% vs. 52.9%, P<0.001) and SB stent implantation (69.1% vs. 52.9%, P<0.001) were significantly higher in the predilation group. During a median follow-up of 36 months, we found no significant difference between the groups in the rate of MACE (9.4% vs. 11.5%; P=0.67) in a propensity score-matched population. In subgroup analysis, patients with minimal luminal diameter of the parent vessel ≤1 mm benefited from SB predilation in terms of preventing abrupt SB occlusion (P for interaction=0.04). Conclusions: For the treatment of true bifurcation lesions, SB predilation improved acute angiographic and procedural outcomes, but could not improve long-term clinical outcomes. It may benefit patients with severe stenosis in the parent vessel.

Original language	English
Pages (from-to)	1293-1301
Number of pages	9
Journal	Circulation Journal
Volume	82
Issue number	5
DOIs	https://doi.org/10.1253/circj.CJ-17-0921
Publication status	Published - 2018

Bibliographical note

Funding Information:
Received September 6, 2017; revised manuscript received January 3, 2018; accepted February 1, 2018; released online March 23, 2018 Time for primary review: 27 days Department of Medicine, Heart, Stroke and Vascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Seung Hwa L., Y.B.S., J.M.L., T.K.P., J.H.Y., J.-Y.H., J.-H.C., S.-H.C., Sang Hoon L., H.-C.G.); Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (J.H.A., K.C.C.), Republic of Korea; Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta (K.C.C.), Canada; Chonnam National University Hospital, Gwangju (M.-H.J.); Seoul National University Hospital, Seoul (H.-S.K.); Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon (J.H.O); and Yonsei University Severance Hospital, Seoul (Y.J.), Republic of Korea The first two authors contributed equally to this work (Seung Hwa L., Y.B.S.).

Publisher Copyright:
© 2018, Japanese Circulation Society. All rights reserved.

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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10.1253/circj.CJ-17-0921

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Lee, S. H., Song, Y. B., Lee, J. M., Park, T. K., Yang, J. H., Hahn, J. Y., Choi, J. H., Choi, S. H., Lee, S. H., Ahn, J. H., Carriere, K. C., Jeong, M. H., Kim, H. S., Oh, J. H., Jang, Y., & Gwon, H. C. (2018). Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―. Circulation Journal, 82(5), 1293-1301. https://doi.org/10.1253/circj.CJ-17-0921

@article{f5cf7041577e428d8f03e067e951e512,

title = "Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―",

abstract = "Background: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach. Methods and Results: A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization. SB predilation was performed in 437 (40.4%) patients. Abrupt (10.5% vs. 11.3%; P=0.76) or final SB occlusion (2.7% vs. 3.9%; P=0.41) showed no differences between the predilation and non-predilation groups. The rates of angiographic success (69.1% vs. 52.9%, P<0.001) and SB stent implantation (69.1% vs. 52.9%, P<0.001) were significantly higher in the predilation group. During a median follow-up of 36 months, we found no significant difference between the groups in the rate of MACE (9.4% vs. 11.5%; P=0.67) in a propensity score-matched population. In subgroup analysis, patients with minimal luminal diameter of the parent vessel ≤1 mm benefited from SB predilation in terms of preventing abrupt SB occlusion (P for interaction=0.04). Conclusions: For the treatment of true bifurcation lesions, SB predilation improved acute angiographic and procedural outcomes, but could not improve long-term clinical outcomes. It may benefit patients with severe stenosis in the parent vessel.",

author = "Lee, {Seung Hwa} and Song, {Young Bin} and Lee, {Joo Myung} and Park, {Taek Kyu} and Yang, {Jeong Hoon} and Hahn, {Joo Yong} and Choi, {Jin Ho} and Choi, {Seung Hyuk} and Lee, {Sang Hoon} and Ahn, {Joong Hyun} and Carriere, {Keumhee C.} and Jeong, {Myung Ho} and Kim, {Hyo Soo} and Oh, {Ju Hyeon} and Yangsoo Jang and Gwon, {Hyeon Cheol}",

note = "Funding Information: Received September 6, 2017; revised manuscript received January 3, 2018; accepted February 1, 2018; released online March 23, 2018 Time for primary review: 27 days Department of Medicine, Heart, Stroke and Vascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Seung Hwa L., Y.B.S., J.M.L., T.K.P., J.H.Y., J.-Y.H., J.-H.C., S.-H.C., Sang Hoon L., H.-C.G.); Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (J.H.A., K.C.C.), Republic of Korea; Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta (K.C.C.), Canada; Chonnam National University Hospital, Gwangju (M.-H.J.); Seoul National University Hospital, Seoul (H.-S.K.); Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon (J.H.O); and Yonsei University Severance Hospital, Seoul (Y.J.), Republic of Korea The first two authors contributed equally to this work (Seung Hwa L., Y.B.S.). Publisher Copyright: {\textcopyright} 2018, Japanese Circulation Society. All rights reserved.",

year = "2018",

doi = "10.1253/circj.CJ-17-0921",

language = "English",

volume = "82",

pages = "1293--1301",

journal = "Circulation Journal",

issn = "1346-9843",

publisher = "Japanese Circulation Society",

number = "5",

}

Lee, SH, Song, YB, Lee, JM, Park, TK, Yang, JH, Hahn, JY, Choi, JH, Choi, SH, Lee, SH, Ahn, JH, Carriere, KC, Jeong, MH, Kim, HS, Oh, JH, Jang, Y & Gwon, HC 2018, 'Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―', Circulation Journal, vol. 82, no. 5, pp. 1293-1301. https://doi.org/10.1253/circj.CJ-17-0921

TY - JOUR

T1 - Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―

AU - Lee, Seung Hwa

AU - Song, Young Bin

AU - Lee, Joo Myung

AU - Park, Taek Kyu

AU - Yang, Jeong Hoon

AU - Hahn, Joo Yong

AU - Choi, Jin Ho

AU - Choi, Seung Hyuk

AU - Lee, Sang Hoon

AU - Ahn, Joong Hyun

AU - Carriere, Keumhee C.

AU - Jeong, Myung Ho

AU - Kim, Hyo Soo

AU - Oh, Ju Hyeon

AU - Jang, Yangsoo

AU - Gwon, Hyeon Cheol

N1 - Funding Information: Received September 6, 2017; revised manuscript received January 3, 2018; accepted February 1, 2018; released online March 23, 2018 Time for primary review: 27 days Department of Medicine, Heart, Stroke and Vascular Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Seung Hwa L., Y.B.S., J.M.L., T.K.P., J.H.Y., J.-Y.H., J.-H.C., S.-H.C., Sang Hoon L., H.-C.G.); Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (J.H.A., K.C.C.), Republic of Korea; Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta (K.C.C.), Canada; Chonnam National University Hospital, Gwangju (M.-H.J.); Seoul National University Hospital, Seoul (H.-S.K.); Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon (J.H.O); and Yonsei University Severance Hospital, Seoul (Y.J.), Republic of Korea The first two authors contributed equally to this work (Seung Hwa L., Y.B.S.). Publisher Copyright: © 2018, Japanese Circulation Society. All rights reserved.

PY - 2018

Y1 - 2018

N2 - Background: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach. Methods and Results: A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization. SB predilation was performed in 437 (40.4%) patients. Abrupt (10.5% vs. 11.3%; P=0.76) or final SB occlusion (2.7% vs. 3.9%; P=0.41) showed no differences between the predilation and non-predilation groups. The rates of angiographic success (69.1% vs. 52.9%, P<0.001) and SB stent implantation (69.1% vs. 52.9%, P<0.001) were significantly higher in the predilation group. During a median follow-up of 36 months, we found no significant difference between the groups in the rate of MACE (9.4% vs. 11.5%; P=0.67) in a propensity score-matched population. In subgroup analysis, patients with minimal luminal diameter of the parent vessel ≤1 mm benefited from SB predilation in terms of preventing abrupt SB occlusion (P for interaction=0.04). Conclusions: For the treatment of true bifurcation lesions, SB predilation improved acute angiographic and procedural outcomes, but could not improve long-term clinical outcomes. It may benefit patients with severe stenosis in the parent vessel.

AB - Background: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach. Methods and Results: A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization. SB predilation was performed in 437 (40.4%) patients. Abrupt (10.5% vs. 11.3%; P=0.76) or final SB occlusion (2.7% vs. 3.9%; P=0.41) showed no differences between the predilation and non-predilation groups. The rates of angiographic success (69.1% vs. 52.9%, P<0.001) and SB stent implantation (69.1% vs. 52.9%, P<0.001) were significantly higher in the predilation group. During a median follow-up of 36 months, we found no significant difference between the groups in the rate of MACE (9.4% vs. 11.5%; P=0.67) in a propensity score-matched population. In subgroup analysis, patients with minimal luminal diameter of the parent vessel ≤1 mm benefited from SB predilation in terms of preventing abrupt SB occlusion (P for interaction=0.04). Conclusions: For the treatment of true bifurcation lesions, SB predilation improved acute angiographic and procedural outcomes, but could not improve long-term clinical outcomes. It may benefit patients with severe stenosis in the parent vessel.

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U2 - 10.1253/circj.CJ-17-0921

DO - 10.1253/circj.CJ-17-0921

M3 - Article

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AN - SCOPUS:85045966608

SN - 1346-9843

VL - 82

SP - 1293

EP - 1301

JO - Circulation Journal

JF - Circulation Journal

IS - 5

ER -

Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―

Abstract

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