Effect of Wire Jailing at Side Branch in 1-Stent Strategy for Coronary Bifurcation Lesions.
JACC Cardiovasc Interv
; 15(4): 443-455, 2022 02 28.
Article
de En
| MEDLINE
| ID: mdl-35210051
ABSTRACT
OBJECTIVES:
This study aimed to determine whether side branch (SB) wire jailing before main vessel (MV) stenting could prevent SB occlusion after the 1-stent strategy for bifurcation percutaneous coronary intervention.BACKGROUND:
The benefits of SB wire jailing in the 1-stent strategy remain unclear.METHODS:
From the COBIS (Coronary Bifurcation Stenting) III registry, 1,890 patients with bifurcation lesions who underwent the 1-stent strategy using second-generation drug-eluting stents were identified and classified into 2 groups according to the use of SB wire jailing wire jailing (n = 819) and non-wire jailing (n = 1,071). The incidence of SB occlusion (Thrombolysis In Myocardial Infarction flow grade <3) and target lesion failure (cardiac death, myocardial infarction, or target lesion revascularization) was compared.RESULTS:
The incidence of final SB occlusion was not significantly different between wire jailing (1.8%) vs non-wire jailing (2.9%; P = 0.182). However, wire jailing at the SB was a significant protective factor for SB occlusion after MV stenting on multivariate analysis and was significantly associated with a lower incidence of SB occlusion in patients with significant stenoses (≥60%) at the SB (5.1% vs 11.3%; odds ratio 0.42; 95% CI 0.19-0.89; P = 0.028) or MV (3.1% vs 6.2%; odds ratio 0.49; 95% CI 0.24-0.95; P = 0.039). During follow-up (median 52 months), the incidence of target lesion failure was not significantly different between wire jailing and non-wire jailing (7.6% vs 6.3%; P = 0.343).CONCLUSIONS:
During bifurcation percutaneous coronary intervention with the 1-stent strategy, wire jailing at the SB was associated with a lower rate of final SB occlusion following MV stenting in patients with severe stenoses at the SB or MV but not with overall bifurcation lesions. Long-term clinical outcomes were comparable between the 2 groups.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Maladie des artères coronaires
/
Endoprothèses à élution de substances
/
Intervention coronarienne percutanée
/
Infarctus du myocarde
Type d'étude:
Etiology_studies
/
Prognostic_studies
Limites:
Humans
Langue:
En
Journal:
JACC Cardiovasc Interv
Sujet du journal:
ANGIOLOGIA
/
CARDIOLOGIA
Année:
2022
Type de document:
Article