Key result
Side branch occlusion was not associated with stent design (CrossFlex 7.7%, NIR 10.5%, GFX 8.8%; P=NS), but was strongly predicted by side branch ostial disease (OR 22.1, 95% CI 9.47-51.49, P<0.001).
Why the study?
Does stent design affect the rate of side branch occlusion after coronary stent placement?
Cohort (n=314)
Does stent design affect the rate of side branch occlusion after coronary stent placement?
Side branch occlusion after coronary stenting is driven by side branch lesion morphology, specifically ostial disease, rather than the specific design of the stent used.
Answers are grounded in this paper and cite their sources.
May shift periprocedural risk focus to ostial disease over stent selection; leaves open causal effects of device design.
This study was performed to assess the immediate and long-term patency of stent-associated side branches (SB) according to the types of stent. A total of 314 patients with 332 lesions (CrossFlex stent 86, NIR 100, GFX 146) had 365 SB (>1 mm) covered by coronary stents. Side branch occlusion (SBO) occurred in 7.7% of CrossFlex stent, in 10.5% of NIR stent and in 8.8% of GFX stent (P = NS). SBO primarily occurred in SB with ostial disease, and the presence of SB ostial disease was the only independent predictors of SBO after stenting (OR 22.1, 95% CI 9.47-51.49, P < 0.001). At 6 months follow-up, 11 of 31 SBO regained the patency, but the remaining SB had persistent SBO. Delayed SBO occurred in 8 SB, being associated with the presence of SB ostial disease and in-stent restenosis. In conclusions, SBO was not associated with the types of stent design, but with the SB lesion morphology.
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Cho et al. (2001) conducted a cohort in Coronary lesions with side branches (n=314). Stent design (CrossFlex, NIR, GFX) vs. Other stent designs was evaluated on Side branch occlusion (SBO) (p=NS). Side branch occlusion was not associated with stent design (CrossFlex 7.7%, NIR 10.5%, GFX 8.8%; P=NS), but was strongly predicted by side branch ostial disease (OR 22.1, 95% CI 9.47-51.49, P<0.001).
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