Retracted : Comparison of First- and Second-Generation Drug-Eluting Stents for Bifurcation Stenting Followed by the Final Kissing-Balloon Technique

Introduction: Percutaneous coronary intervention (PCI) for bifurcated lesions is challenging. We assessed the procedural performance and clinical outcomes of first- and second-generation drug-eluting stents (DES) in bifurcation stenting followed by the final kissing-balloon (FKB) technique. Methods: We retrospectively analyzed 192 patients (222 lesions) who underwent PCI for bifurcated lesions. In all cases, lesions were stented, followed by FKB. Clinical outcomes were compared for the two generations-first generation (80 patients/88 lesions) vs. second generation (112 patients/134 lesions). The primary endpoint was target-lesion failure (TLF), defined as cardiac death, target-lesion revascularization, or target-lesion-related stent thrombosis at 2 years. Results: TLF incidence was higher for first-generation DES than for second-generation DES (12.5% vs. 2.7%; P = 0.001). A Cox proportional hazard analysis revealed that first-generation DES (hazard ratio [HR]: 6.32, 95% confidence interval [CI]: 1.72-23.1, P = 0.005), age ≥ 75 years (HR: 1.55, 95% CI: 1.17-2.03, P = 0.001), and left main trunk PCI (HR: 3.89, 95% CI: 1.30-11.5, P = 0.01) were independent predictors of TLF after bifurcation stenting followed by FKB. Notably, age ≥ 75 years (HR: 1.70, 95% CI: 1.27-2.28, P < 0.01) and left main trunk PCI (HR: 4.72, 95% CI: 1.35-16.5, P = 0.01) were associated with an increased TLF for patients who were treated with first-generation DES. No prognostic factor of TLF was found for patients with second-generation DES. Conclusions: In bifurcation stenting followed by FKB, outcomes are better for second-generation DES than for first-generation DES.