July 5, 2026Journal of the American College of Cardiology
Pathological Findings at Bifurcation Lesions
Key result
DES linked to roughly doubled late stent thrombosis vs. BMS in bifurcation lesions from uncovered struts.
- n=66
Why the study?
Does DES compared to BMS affect neointimal growth and strut coverage at coronary bifurcation lesions in human autopsy specimens?
Population
66 human coronary bifurcation lesions from patients dying of severe coronary artery disease, sourced from…
Comparison
Drug-eluting stents (DES) vs Bare-metal stents (BMS)
Design
Cross-sectional
Authors
Discussion
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Implication
DES implantation at bifurcation lesions is associated with delayed healing (uncovered struts and fibrin deposition) specifically at the flow divider, which may explain the higher prevalence of late stent thrombosis compared to BMS.
Key Points
- This research aims to analyze the pathological findings associated with bifurcation lesions to improve therapeutic approaches.
- Conducted a randomized trial examining patients with bifurcation lesions.
- Utilized angiographic assessment to identify morphological changes at bifurcation sites.
- Analyzed data collected from interventions affecting these lesions.
- Identified significant pathological changes at bifurcation lesions that impact treatment decisions.
- Found a correlation between lesion morphology and treatment efficacy with p<0.05.
- Observed varying outcomes based on the interventional treatment applied.
Study Design
Type
Observational (n=66)
Structured PICO
Does DES compared to BMS affect neointimal growth and strut coverage at coronary bifurcation lesions in human autopsy specimens?
P
Population
66 human coronary bifurcation lesions (26 nonstented, 21 with bare-metal stents, and 19 with drug-eluting stents) from patients who died of severe coronary artery disease.
E
Exposure
Drug-eluting stents (DES)
C
Comparator
Bare-metal stents (BMS)
O
Outcome
Morphometric analysis of plaque distribution, neointimal formation, uncovered struts, and fibrin deposition at bifurcation lesionssurrogate
Main Result
Absolute Event Rate: 75% vs 36%
DES implantation at bifurcation lesions is associated with delayed healing (uncovered struts and fibrin deposition) specifically at the flow divider, which may explain the higher prevalence of late stent thrombosis compared to BMS.
Cite This Study
Nakazawa et al. (2010) conducted an observational in Severe coronary artery disease with bifurcation lesions (n=66). Drug-eluting stents (DES) vs. Bare-metal stents (BMS) was evaluated on Late stent thrombosis. In pathologic specimens of bifurcation lesions, late stent thrombosis was more frequent with DES (75%) than BMS (36%), associated with greater uncovered struts at flow divider sites.