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Outcomes at 1 Year of Non-Left Main Trunk Bifurcation Lesions Treated With a 2-Stent Strategy Using Newer-Generation Everolimus-Eluting Stents
Circulation Journal ( IF 3.3 ) Pub Date : 2021-10-25 , DOI: 10.1253/circj.cj-20-1281
Koya Okabe 1 , Masanobu Ohya 1 , Akihiro Ikuta 1 , Makoto Takamatsu 1 , Kohei Osakada 1 , Takenobu Shimada 1 , Katsuya Miura 1 , Shunsuke Kubo 1 , Takeshi Tada 1 , Hiroyuki Tanaka 1 , Yasushi Fuku 1 , Harumi Katoh 1 , Kazushige Kadota 1
Affiliation  

Background:Percutaneous coronary intervention (PCI) for coronary bifurcation lesions using the 2-stent strategy remains a challenging procedure for interventionalists because of the higher incidence of in-stent restenosis (ISR) and adverse events. ISR predictors in patients treated with newer-generation everolimus-eluting stents (EES) and the 2-stent strategy remain unknown. Hence, we aimed to evaluate the 1-year clinical and angiographic outcomes of non-left main trunk (LMT) bifurcation lesions treated with the 2-stent strategy using newer-generation EES.

Methods and Results:The study sample consisted of 262 non-LMT bifurcation lesions treated using culotte or T-stenting with EES between 2010 and 2018. One-year post-procedural angiographic and clinical examinations were conducted in 208 (79.4%) and 260 (99.2%) lesions, respectively. The primary outcome measure was the 1-year post-procedural ISR rate, which was found to be 15.9%. Independent predictors of 1-year post-procedural ISR were long side branch lesions (adjusted odds ratio [aOR] 2.31; 95% confidence interval [CI] 1.02–5.23; P=0.04) and 3-link EES implantation (aOR 2.45; 95% CI 1.07–5.61; P=0.03). The 1-year cumulative incidence of target lesion revascularization was 3.5%.

Conclusions:The 1-year clinical outcomes of non-LMT bifurcation lesions treated with the 2-stent strategy using EES were acceptable. Long side branch lesions and lesions treated with 3-link EES were independent predictors of 1-year post-procedural ISR.



中文翻译:

使用新一代依维莫司洗脱支架采用 2 支架策略治疗 1 年非左侧主干分叉病变的结果

背景:由于支架内再狭窄 (ISR) 和不良事件的发生率较高,使用 2 支架策略对冠状动脉分叉病变进行经皮冠状动脉介入治疗 (PCI) 仍然是介入医师具有挑战性的程序。接受新一代依维莫司洗脱支架 (EES) 和 2 支架策略治疗的患者的 ISR 预测因子仍然未知。因此,我们旨在评估使用新一代 EES 的 2 支架策略治疗的非左主干 (LMT) 分叉病变的 1 年临床和血管造影结果。

方法和结果:研究样本包括 2010 年至 2018 年间使用裙裤或 T 型支架联合 EES 治疗的 262 例非 LMT 分叉病变。对 208 例(79.4%)和 260 例(79.4%)进行了一年的术后血管造影和临床检查。 99.2%) 病变,分别。主要结局指标是术后 1 年的 ISR 率,发现为 15.9%。术后 1 年 ISR 的独立预测因素是长侧支病变(调整优势比 [aOR] 2.31;95% 置信区间 [CI] 1.02-5.23;P=0.04)和 3-link EES 植入(aOR 2.45;95 % CI 1.07–5.61;P=0.03)。靶病变血运重建的 1 年累积发生率为 3.5%。

结论:采用 EES 的 2 支架策略治疗非 LMT 分叉病变的 1 年临床结果是可以接受的。长侧枝病变和用 3-link EES 治疗的病变是术后 1 年 ISR 的独立预测因子。

更新日期:2021-10-24
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