Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis

Young Hak Kim; Jae Hwan Lee; Jae Hyung Roh; Jung Min Ahn; Sung Han Yoon; Duk Woo Park; Jong Young Lee; Sung Cheol Yun; Soo Jin Kang; Seung Whan Lee; Cheol Whan Lee; Ki Bae Seung; Won Yong Shin; Nae Hee Lee; Bong Ki Lee; Sang Gon Lee; Chang Wook Nam; Junghan Yoon; Joo Young Yang; Min Su Hyon; Keun Lee; Jae Sik Jang; Hyun Sook Kim; Seong Wook Park; Seung Jung Park

doi:10.1016/j.jcin.2015.01.016

Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis

Young Hak Kim, Jae Hwan Lee, Jae Hyung Roh, Jung Min Ahn, Sung Han Yoon, Duk Woo Park, Jong Young Lee, Sung Cheol Yun, Soo Jin Kang, Seung Whan Lee, Cheol Whan Lee, Ki Bae Seung, Won Yong Shin, Nae Hee Lee, Bong Ki Lee, Sang Gon Lee, Chang Wook Nam, Junghan Yoon, Joo Young Yang, Min Su HyonKeun Lee, Jae Sik Jang, Hyun Sook Kim, Seong Wook Park, Seung Jung Park

Internal Medicine

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

66 Citations (Scopus)

Abstract

Objectives This study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions. Background The optimal bifurcation stenting technique needs to be evaluated. Methods The trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non-left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis. Results Between the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9% versus 9.3% (p = 0.064), comprising 15.1% versus 3.7% for the main branch (p = 0.004) and 2.8% versus 5.6% for the SB (p = 0.50) from 214 patients (69.9%) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0% versus 11.6% between the routine final kissing balloon and leave-alone groups (p = 0.57). In another randomization study for diseased SB lesions, 28.2% in the single-stent group received SB stents. From 300 patients (71.6%) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4% versus 11.0% (p = 0.44), comprising 5.2% versus 4.8% for the main branch (p = 0.90) and 3.9% versus 8.3% for the SB (p = 0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9% versus 18.5% (p = 0.84). Conclusions Angiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non-left main bifurcation lesions once the procedure was performed successfully.

Original language	English
Pages (from-to)	550-560
Number of pages	11
Journal	JACC: Cardiovascular Interventions
Volume	8
Issue number	4
DOIs	https://doi.org/10.1016/j.jcin.2015.01.016
Publication status	Published - 2015 Apr 20

Bibliographical note

Funding Information:
This study was partly supported by a grant from the Korean Society of Interventional Cardiology (2008-1) and Korea Healthcare Technology R&D Project , Ministry of Health and Welfare , Republic of Korea (HI12C0630, HI10C2020, and HI10C2020). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Publisher Copyright:
© 2015 American College of Cardiology Foundation.

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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10.1016/j.jcin.2015.01.016

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Kim, Y. H., Lee, J. H., Roh, J. H., Ahn, J. M., Yoon, S. H., Park, D. W., Lee, J. Y., Yun, S. C., Kang, S. J., Lee, S. W., Lee, C. W., Seung, K. B., Shin, W. Y., Lee, N. H., Lee, B. K., Lee, S. G., Nam, C. W., Yoon, J., Yang, J. Y., ... Park, S. J. (2015). Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis. JACC: Cardiovascular Interventions, 8(4), 550-560. https://doi.org/10.1016/j.jcin.2015.01.016

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title = "Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis",

abstract = "Objectives This study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions. Background The optimal bifurcation stenting technique needs to be evaluated. Methods The trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non-left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis. Results Between the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9% versus 9.3% (p = 0.064), comprising 15.1% versus 3.7% for the main branch (p = 0.004) and 2.8% versus 5.6% for the SB (p = 0.50) from 214 patients (69.9%) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0% versus 11.6% between the routine final kissing balloon and leave-alone groups (p = 0.57). In another randomization study for diseased SB lesions, 28.2% in the single-stent group received SB stents. From 300 patients (71.6%) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4% versus 11.0% (p = 0.44), comprising 5.2% versus 4.8% for the main branch (p = 0.90) and 3.9% versus 8.3% for the SB (p = 0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9% versus 18.5% (p = 0.84). Conclusions Angiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non-left main bifurcation lesions once the procedure was performed successfully.",

author = "Kim, {Young Hak} and Lee, {Jae Hwan} and Roh, {Jae Hyung} and Ahn, {Jung Min} and Yoon, {Sung Han} and Park, {Duk Woo} and Lee, {Jong Young} and Yun, {Sung Cheol} and Kang, {Soo Jin} and Lee, {Seung Whan} and Lee, {Cheol Whan} and Seung, {Ki Bae} and Shin, {Won Yong} and Lee, {Nae Hee} and Lee, {Bong Ki} and Lee, {Sang Gon} and Nam, {Chang Wook} and Junghan Yoon and Yang, {Joo Young} and Hyon, {Min Su} and Keun Lee and Jang, {Jae Sik} and Kim, {Hyun Sook} and Park, {Seong Wook} and Park, {Seung Jung}",

note = "Funding Information: This study was partly supported by a grant from the Korean Society of Interventional Cardiology (2008-1) and Korea Healthcare Technology R&D Project , Ministry of Health and Welfare , Republic of Korea (HI12C0630, HI10C2020, and HI10C2020). The authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: {\textcopyright} 2015 American College of Cardiology Foundation.",

year = "2015",

month = apr,

day = "20",

doi = "10.1016/j.jcin.2015.01.016",

language = "English",

volume = "8",

pages = "550--560",

journal = "JACC: Cardiovascular Interventions",

issn = "1936-8798",

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Kim, YH, Lee, JH, Roh, JH, Ahn, JM, Yoon, SH, Park, DW, Lee, JY, Yun, SC, Kang, SJ, Lee, SW, Lee, CW, Seung, KB, Shin, WY, Lee, NH, Lee, BK, Lee, SG, Nam, CW, Yoon, J, Yang, JY, Hyon, MS, Lee, K, Jang, JS, Kim, HS, Park, SW & Park, SJ 2015, 'Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis', JACC: Cardiovascular Interventions, vol. 8, no. 4, pp. 550-560. https://doi.org/10.1016/j.jcin.2015.01.016

TY - JOUR

T1 - Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis

AU - Kim, Young Hak

AU - Lee, Jae Hwan

AU - Roh, Jae Hyung

AU - Ahn, Jung Min

AU - Yoon, Sung Han

AU - Park, Duk Woo

AU - Lee, Jong Young

AU - Yun, Sung Cheol

AU - Kang, Soo Jin

AU - Lee, Seung Whan

AU - Lee, Cheol Whan

AU - Seung, Ki Bae

AU - Shin, Won Yong

AU - Lee, Nae Hee

AU - Lee, Bong Ki

AU - Lee, Sang Gon

AU - Nam, Chang Wook

AU - Yoon, Junghan

AU - Yang, Joo Young

AU - Hyon, Min Su

AU - Lee, Keun

AU - Jang, Jae Sik

AU - Kim, Hyun Sook

AU - Park, Seong Wook

AU - Park, Seung Jung

N1 - Funding Information: This study was partly supported by a grant from the Korean Society of Interventional Cardiology (2008-1) and Korea Healthcare Technology R&D Project , Ministry of Health and Welfare , Republic of Korea (HI12C0630, HI10C2020, and HI10C2020). The authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: © 2015 American College of Cardiology Foundation.

PY - 2015/4/20

Y1 - 2015/4/20

N2 - Objectives This study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions. Background The optimal bifurcation stenting technique needs to be evaluated. Methods The trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non-left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis. Results Between the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9% versus 9.3% (p = 0.064), comprising 15.1% versus 3.7% for the main branch (p = 0.004) and 2.8% versus 5.6% for the SB (p = 0.50) from 214 patients (69.9%) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0% versus 11.6% between the routine final kissing balloon and leave-alone groups (p = 0.57). In another randomization study for diseased SB lesions, 28.2% in the single-stent group received SB stents. From 300 patients (71.6%) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4% versus 11.0% (p = 0.44), comprising 5.2% versus 4.8% for the main branch (p = 0.90) and 3.9% versus 8.3% for the SB (p = 0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9% versus 18.5% (p = 0.84). Conclusions Angiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non-left main bifurcation lesions once the procedure was performed successfully.

AB - Objectives This study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions. Background The optimal bifurcation stenting technique needs to be evaluated. Methods The trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non-left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis. Results Between the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9% versus 9.3% (p = 0.064), comprising 15.1% versus 3.7% for the main branch (p = 0.004) and 2.8% versus 5.6% for the SB (p = 0.50) from 214 patients (69.9%) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0% versus 11.6% between the routine final kissing balloon and leave-alone groups (p = 0.57). In another randomization study for diseased SB lesions, 28.2% in the single-stent group received SB stents. From 300 patients (71.6%) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4% versus 11.0% (p = 0.44), comprising 5.2% versus 4.8% for the main branch (p = 0.90) and 3.9% versus 8.3% for the SB (p = 0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9% versus 18.5% (p = 0.84). Conclusions Angiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non-left main bifurcation lesions once the procedure was performed successfully.

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Randomized comparisons between different stenting approaches for bifurcation coronary lesions with or without side branch stenosis

Abstract

Bibliographical note

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