title: Immediate and long-term clinical and angiographic results from Wiktor stent treatment for true bifurcation narrowings.
abstract: From January 1996 to December 1998, 90 consecutive patients with true bifurcation lesions underwent percutaneous coronary angioplasty with Wiktor stent implantation in our centers. In 1 group (group I, n = 45), a simple approach (main vessel stenting and balloon angioplasty of the side branch) was pursued. In the other group (group II, n = 45), both the main vessel and the side branch were stented ("T" technique). There was no significant difference in clinical and angiographic characteristics between the 2 groups. Angiographic and procedural successes were 100% and 95.6%, respectively, in both groups. Angiographic results for the side branch were better in group II than in group I. In-hospital and long-term (12 month) major cardiac events were similar in the 2 groups. Target lesion revascularization was 15.5% in group I and 35.5% in group II (p = 0.12). In the main vessel, restenosis rate was 12.5% in group I and 25% in group II (p = 0.15). In the side branch, restenosis rate was 37.5% in group II and 12.5% in group I (p = <0.05; odds ratio 2.42; 95% confidence interval 1.05 to 6.26). Event-free probability at 12 months was 61% in group II and 80% in group I (p = 0.10). When dealing with true bifurcation lesions, a simple strategy is associated with a lower risk of restenosis in the side branch. In contrast, a complex approach does not appear to give any benefit in terms of early or long-term outcome or restenosis rate.
authors.affiliation: Vita e Salute University, San Raffaele Hospital, Milan, Italy. anzangelo@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: Anzuini
authors.forename: C
authors.initials: C
authors.lastname: Briguori
authors.forename: S
authors.initials: S
authors.lastname: Rosanio
authors.forename: M
authors.initials: M
authors.lastname: Tocchi
authors.forename: P
authors.initials: P
authors.lastname: Pagnotta
authors.forename: H
authors.initials: H
authors.lastname: Bonnier
authors.forename: G
authors.initials: G
authors.lastname: Gimelli
authors.forename: F
authors.initials: F
authors.lastname: Airoldi
authors.forename: A
authors.initials: A
authors.lastname: Margonato
authors.forename: V
authors.initials: V
authors.lastname: Legrand
authors.forename: A
authors.initials: A
authors.lastname: Colombo
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D017023:Coronary Angiography; D023903:Coronary Restenosis; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects