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December 20, 2001Catheterization and Cardiovascular Interventions

A stepwise strategy for the stent treatment of bifurcated coronary lesions

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Why the study?

Does a stepwise provisional stenting strategy provide good immediate and long-term outcomes in patients with major coronary bifurcation stenosis?

Population

126 patients with major coronary bifurcation stenosis, mean age 58 +/- 11 years.

Design

Cohort

Follow-up

15 months

Authors

MPManuel PanUniversidad de Las Palmas de Gran CanariaJLJosé Suárez de LezoInterventional / Structural CardiologyAMAlfonso MedinaEpsom and St Helier University Hospitals NHS Trust

Discussion

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Overview

May support provisional stenting to limit side-branch intervention in bifurcation lesions; hypothesis-generating pending randomized confirmation.

Structured PICO

Does a stepwise provisional stenting strategy provide good immediate and long-term outcomes in patients with major coronary bifurcation stenosis?

P
Population
126 patients with major coronary bifurcation stenosis, mean age 58 +/- 11 years.
I
Intervention
A three-step phase strategy for stent treatment: 1) balloon angioplasty of the side branch followed by stenting of the parent vessel; 2) balloon redilation of the side-branch origin across the metallic structure of the stent; 3) stenting of the side-branch origin. Progression to the next step was triggered by failure to achieve <50% residual stenosis at the side branch.
O
Outcome
Immediate procedural success and overall major cardiac event-free probability at 15 monthscomposite

A stepwise provisional stenting approach for coronary bifurcation lesions avoids side-branch stenting in most patients while providing good immediate and long-term results.

Cite This Study

Pan et al. (2001) studied this question.

synapsesocial.com/papers/6a83d34e5dc7077fe9c586fchttps://doi.org/10.1002/ccd.10057
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Stenting of bifurcation lesions: Classification, treatments, and results2000 · 386 citations
  2. 2The V-stent: A novel technique for coronary bifurcation stenting1996 · 77 citations
  3. 3“T”-shaped stent placement: A technique for the treatment of dissected bifurcation lesions1996 · 87 citations
  4. 4Trouser-like stenting: A new technique for bifurcation lesions1997 · 51 citations
  5. 5Modified “T” stenting: A technique for kissing stents in bifurcational coronary lesion1998 · 65 citations