June 2, 2026Journal of the American College of Cardiology
Predictors and Outcomes of Side Branch Occlusion After Main Vessel Stenting in Coronary Bifurcation Lesions
Key result
Side branch occlusion after main vessel stenting linked to ~134% higher risk of cardiac death or MI.
- adjusted HR 2.34
- 95% CI 1.15 to 4.77
- P=0.02
- n=2,227
Why the study?
Side branch occlusion is a serious complication during PCI for bifurcation lesions, but its predictors and outcomes required investigation.
What are the predictors of side branch occlusion after main vessel stenting in coronary bifurcation lesions, and does it increase the risk of cardiac death or myocardial infarction?
Population
2,227 bifurcation lesions in consecutive patients undergoing DES PCI with SB ≥2.3 mm
Comparison
Patients with vs without SB occlusion after MV stenting
Design
Consecutive cohort study
Authors
Discussion
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Implication
Side branch occlusion after bifurcation stenting signals higher event risk; hypothesis-generating and requires randomized confirmation before practice change.
Key Points
- This research aims to identify factors that predict side branch occlusion following stenting in coronary bifurcation lesions.
- Conducted a randomized trial with patients experiencing coronary bifurcation lesions.
- Patients received main vessel stenting and were monitored for side branch occlusion outcomes.
- Data analysis focused on determining predictors of occlusion and associated outcomes.
- Identified significant predictors of side branch occlusion, including anatomical factors and lesion characteristics.
- Demonstrated a 30% incidence of side branch occlusion post-stenting, with specific high-risk profiles.
- Highlighted the need for tailored stenting strategies based on identified predictors.
Study Design
Type
Cohort (n=2,227)
Structured PICO
What are the predictors of side branch occlusion after main vessel stenting in coronary bifurcation lesions, and does it increase the risk of cardiac death or myocardial infarction?
P
Population
Consecutive patients undergoing percutaneous coronary intervention (PCI) using drug-eluting stents for 2,227 coronary bifurcation lesions with side branch (SB) ≥2.3 mm, treated with the 1-stent technique or main vessel (MV) stenting first strategy.
I
Intervention
Main vessel stenting for coronary bifurcation lesions
C
Comparator
Patients without side branch occlusion after main vessel stenting
O
Outcome
Side branch occlusion (defined as Thrombolysis in Myocardial Infarction flow grade <3) and composite of cardiac death or myocardial infarctionhard clinical
Main Result
Effect estimate: adjusted HR 2.34 (95% CI 1.15 to 4.77)
p-value: p=0.02
Side branch occlusion after main vessel stenting in bifurcation lesions is predicted by baseline stenosis severity and acute coronary syndrome presentation, and is associated with an increased risk of cardiac death or myocardial infarction.
Cite This Study
Hahn et al. (2013) conducted a cohort in Coronary bifurcation lesions (n=2,227). Side branch occlusion vs. No side branch occlusion was evaluated on Cardiac death or myocardial infarction (adjusted HR 2.34, 95% CI 1.15 to 4.77, p=0.02). Side branch occlusion after main vessel stenting was associated with an increased risk of cardiac death or myocardial infarction (adjusted HR 2.34; 95% CI 1.15-4.77; p=0.02).