Pilot results of stenting bifurcation stenoses of coronary arteries


Cite item

Full Text

Abstract

Aim. To study effectiveness of various types of coronary stenting in bifurcation stenoses. Material and methods. Fifty six patients with bifurcation stenoses were divided into 2 groups: stenting of the basic and side branch of the coronary artery (CA) was made in group 1 patients (n = 27), stenting of the basic branch and balloon angioplasty of the side branch were made in group 2 (n = 29). Primary clinical and angiographic response reached 96 and 90% in groups 1 and 2, respectively. Complications were absent in group 1, occurred in 13.7% cases in group 2 (the difference was insignificant). One year after the procedure lethal outcomes were absent. The number of unfavourable clinical outcomes was higher in group 1 (25.9 and 13.7%, respectively, p = 0.4). The rate of restenoses detected angiographically was not significantly different in group 1 and 2 (33 and 26%, respectively). Conclusion. Stenting of bifurcation stenoses brings about good short-term and satisfactory long-term results in most of the patients. The rate of the complications was low. Two stents implantation (in basic and side branches) has no significant advantages over stenting of the basic CA and balloon angioplasty of its side branch.

References

  1. Clark D. A. Complex P. Т. С. A. III. Bifurcation lesion. In: Clark D. A. Coronary angioplasty. 2-nd ed. Chichester: WileyLiss Inc.; 63-68.
  2. Vetrovec G. W., Cowley M. J., Wolfgang Т. С. et al. Effects of percutaneous transluminal coronary angioplasty on lesion-associated branches. Am. Heart J. 1985; 109: 921-925.
  3. Roller P., Safian R. D. Bifurcation stenosis. In: Freed M., Grines C., Safian R. D., eds. The new manual of interventional cardiology. Birmingham, MI: Physicians press; 1996.
  4. Meier В., Gnintzig A. R., King S. B. Ill et al. Risk of side branch occlusion during coronary angioplasty. Am. J. Cardiol. 1984; 53: 10-14.
  5. Mathias D. W., Mooney J. F., Lange H. W. et al. Frequency of success and complications of coronary angioplasty of a stenosis at the ostium of a branch vessel. Am. J. Cardiol. 1991; 67: 491-495.
  6. Weinstein J. S., Balm D. S., Sipperly M. E. Salvage of branch vessel during bifurcation lesion angioplasty: Acute and long follow up. Cathet. Cardiovasc. Diagn. 1991; 22: 1-6.
  7. Alibadi D., Tilli F. V., Bowers T. R. et al. Incidence and angiographic predictors of side branch occlusion following high pressure intracoronary stenting. Am. J. Cardiol. 1997; 80: 994-997.
  8. Fischman D. L., Savage M. P., Leon M. B. et al. Fate of lesion-related side branches after coronary stenting. J. Am. Coll. Cardiol. 1993; 22: 1641-1646.
  9. Rihal С. S., Garratt K. N., Holmes D. R. et al. Rotational atherectomy for bifurcation lesions of coronary circulation: technique and initial experience. Int. J. Cardiol. 1998; 65: 1 - 9.
  10. Dauerman H., Higgins P. J., Sparano A. M. et al. Mechanical debulking versus balloon angioplasty for the treatment of true bifurcation lesions. J. Am. Coll. Cardiol. 1998; 32: 1845-1852.
  11. Serniys P. W., de Jaegere P., Kiemeneij F. et al. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. BENESTENT study group. N. Engl. J. Med. 1994; 331: 496-501.
  12. Fischman D. L., Leon M. В., Bairn D. S. et al. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. Stent Restenosis Study Investigators. N. Engl. J. Med. 1994; 331: 496- 501.
  13. Carrie D., Elbaz M., Damrin G. et al. Coronary stenting of bifurcation lesion using "T" or "reverse Y" configuration with Wiktor stent. Am. J. Cardiol. 1998; 82: 1418-1421.
  14. Suwaidi J. A., Yeh W., Cohen H. A. et al. Immediate and oneyear outcome in patients with coronary bifurcation lesions in the modern era (NHLBI dynamic registry). Am. J. Cardiol. 2001; 87: 1139-1144.
  15. Reimers В., Colombo A. Bifurcation lesions. In: Colombo A., Tobis J. Techniques in coronary artery stenting. Martin Dunitz Ltd; 2000; 171-204.
  16. Lincoff A. M., Califf R. M., Anderson К. М. et al. Evidence for prevention of death and myocardial infarction with platelet membrane glycoprotein Ilb/IIIa receptor blocade by abciximab (c7E3 Fab) among patients with unstable angina undergoing percutaneous coronary revascularization. EPIC Investigators Evaluation of 7E3 in Preventing Ischemic Complications. J. Am. Coll. Cardiol. 1997; 30: 149-156.
  17. The Epistent Investigators. Randomized placebo-controlled and balloon-angioplasty-controlled trial to assess safety of coronary stenting with use of platelet glycoprotein Ilb/IIIa blocade. Lancet 1998; 352: 87-92.
  18. Morice M. C., Serruys P. W., Sousa J. E. et al. A randomized comparison of a sirolimuseluting stent with a standard stent for coronary revascularization. N. Engl. J. Med. 2002; 346: 1773- 1780.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2004 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies