Non-Left Main Bifurcation Lesion PCI Strategies

Non-Left Main Bifurcation Lesion PCI Strategies Bifurcation lesions may be noted in almost one third of cases for percutaneous coronary intervention. Outcomes for bifurcation lesions are worse compared to non-bifurcation lesions. The two important strategies for addressing a coronary bifurcation lesion are planned one stent strategy or provisional stenting and elective two stent strategy. In provisional stenting, side branch is stented only if unavoidable. A multicenter registry of 2044 patients compared the two strategies in non-left main bifurcation lesions. There were 1551 bifurcation lesions of left anterior descending coronary artery and 493 non-LAD bifurcation lesions. Target lesion failure was the primary outcome evaluated in the study. It was a composite of cardiac death, myocardial infarction and target lesion revascularization. Over a follow up period of 38 months, non-LAD bifurcation lesions treated with two stent strategy had more frequent target lesion failure (20.7% vs. 6.3%, p < 0.01) and target lesion revascularization (18.2% vs. 6.3%, p < 0.01). There was no significant difference in the outcome among LAD bifurcation lesions between the two strategies. Authors of the report suggested three possible reasons for the difference between LAD and non-LAD lesions in their study. (1) Less frequent use of final kissing balloon inflation in the non-LAD group. (2) Less frequent use of intravascular ultrasound guided PCI (3)  Difference in the angle between parent...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Angiography and Interventions Coronary Interventions Source Type: blogs