October 1, 2012EuroIntervention
Angiographic and clinical outcome of percutaneous coronary intervention for in-stent restenosis of bifurcated lesions
Key result
PCI for restenotic bifurcated lesions achieved 95.3% procedural success, and single DES on the main vessel yielded lower 1-year MACE compared to other strategies (10.8% vs 29.6%; p=0.04).
Why the study?
Does percutaneous coronary intervention provide acceptable angiographic and clinical outcomes in patients with in-stent restenosis of bifurcated lesions?
Population
64 consecutive patients undergoing percutaneous coronary intervention for restenosis of one bifurcated…
Comparison
Percutaneous coronary intervention for… vs Comparison between single drug-eluting stent on…
Design
Cohort
Follow-up
one year
Authors
Discussion
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Implication
Single DES on main vessel may lower MACE in restenotic bifurcations; hypothesis-generating and requires randomized confirmation.
Study Design
Type
Observational (n=64)
Multicenter
No
Structured PICO
Does percutaneous coronary intervention provide acceptable angiographic and clinical outcomes in patients with in-stent restenosis of bifurcated lesions?
P
Population
64 consecutive patients undergoing percutaneous coronary intervention for restenosis of one bifurcated lesion previously treated by stent implantation at a single centre
I
Intervention
Percutaneous coronary intervention (PCI) for restenosis of stented bifurcated lesions (strategies included single drug-eluting stent on main vessel, balloon only, double-stenting, or bare-metal stent)
C
Comparator
Comparison between single drug-eluting stent (DES) on main vessel versus balloon only PCI, double-stenting technique, or bare-metal stent (BMS)
O
Outcome
Angiographic and procedural success, defined as final residual stenosis ≤30% in the main vessel with TIMI 3 flow in both main vessel and side branch, and stenosis ≤50% in the side branch without death, myocardial infarction or target vessel revascularisation during hospitalisationcomposite
PCI for in-stent restenosis of bifurcated lesions is feasible with high procedural success, and a single DES strategy on the main vessel is associated with better long-term clinical outcomes compared to other approaches.
Cite This Study
Coroleu et al. (2012) conducted an observational in In-stent restenosis of bifurcated lesions (n=64). Percutaneous coronary intervention (PCI) was evaluated on Angiographic and procedural success (final residual stenosis ≤30% in main vessel with TIMI 3 flow in both MV and side branch, and stenosis ≤50% in SB without in-hospital death, MI, or TVR). PCI for restenotic bifurcated lesions achieved 95.3% procedural success, and single DES on the main vessel yielded lower 1-year MACE compared to other strategies (10.8% vs 29.6%; p=0.04).