Systematic isolated post-dilatation of the side branch as part of the provisional stent technique in the percutaneous treatment of coronary bifurcations. CR12 Registry.

ABSTRACT

AIMS: To analyse systematic isolated post-dilatation of the side branch as a part of provisional stent technique. METHODS: 1960 angioplasties performed in two centres were prospectively registered, of which 382 were coronary bifurcations with a side branch>2mm. In centre A, isolated post-dilatation of the side branch was performed regardless its impairment after main vessel stenting. In centre B, side branch post-dilatation was performed only if it was severely affected after stent implantation. RESULTS: There was no difference between the two centres in the rate of side branch affection after stent implantation (A 44.6 vs B 49.3%, p=0.48) nor in the procedural success rate (A 98.6% vs B 96.7%, p=0.45). After one-year follow-up, a reduction of cardiovascular events was observed in centre A (A 4.4% vs B 10.4%, p=0.043) with a trend towards lower cardiac mortality (A 2.2% vs B 6.5%, p=0.093) and stent thrombosis (A 0% vs B 2.6%, p=0.077). There were no differences in the rate of myocardial infarction related to the treated artery (A 1.4% vs B 3.9%, p=0.29), or target lesion revascularization (A 1.4% vs. B 3.2%, p=0.45). CONCLUSIONS: Systematic isolated post-dilatation of the side branch in the provisional stent technique was associated with a high angiographic success rate, and a low rate of cardiovascular events during follow-up. Although the study design does not allow definitive conclusions, this strategy could be considered a valid option in some cases or even as part of the provisional stent technique.