September 23, 2009Circulation Cardiovascular Interventions
Double Versus Single Stenting for Coronary Bifurcation Lesions
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Discussion
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Implication
Meta-analysis reveals higher myocardial infarction risk with double versus single stenting in coronary bifurcation lesions, indicating a simpler single-stent approach is safer.
Key Points
- To assess the comparative safety and clinical efficacy of double versus single stenting strategies in patients undergoing percutaneous coronary intervention for coronary bifurcation lesions.
- Meta-analysis of 6 randomized trials comprising a total of 1,642 patients with coronary bifurcation lesions.
- Evaluated clinical outcomes following percutaneous coronary intervention using double stenting (main vessel and side branch) versus single stenting (main vessel only) using fixed-effects and Bayesian models.
- Double stenting was associated with a significantly higher risk of myocardial infarction compared to single stenting (RR 1.78, P=0.001 by fixed effects; RR 1.49 with Bayesian meta-analysis).
- Double stenting suggested an increased risk of stent thrombosis (RR 1.85, P=0.19), with no significant differences observed for death (RR 0.81, P=0.66) or target lesion revascularization (RR 1.09, P=0.67).
Cite This Study
Katritsis et al. (2009) studied this question.