Contemporary coronary intervention in bifurcation lesions--two-year follow-up in an unselected cohort.
BACKGROUND
Optimization of coronary angioplasty in bifurcation lesions remains a major challenge for percutaneous revascularization techniques.


METHODS
We evaluated procedural success, major in-hospital complications, target vessel revascularization, and 2-year clinical outcomes in 45 patients who underwent PTCA of a bifurcation lesion using currently available techniques and rigorous criteria for optimal immediate


RESULTS
Angiographic success occurred in 100% of the parent vessels and in 84.4% of both vessels. Within the first 24 hours, there were no deaths or Q-wave myocardial infarction. Three non-Q-wave myocardial infarctions occurred (6.6%) and one emergency PTCA was necessary (2.2%). Therefore, clinical success was achieved in 91.2% of these patients. At 2-year follow-up, 3 cardiac deaths had occurred, the target revascularization rate was 20%, and the total frequency of major adverse cardiac events (MACE) was 37.8%.


CONCLUSIONS
Optimization of coronary angioplasty in bifurcation lesions is possible and results in a high angiographic success rate, low risk of acute complications and acceptable long-term clinical outcomes. However, the fairly high incidence of MACE at 2 years suggests that bifurcation lesions remain a challenge in everyday practice despite contemporary intervention methods and the use of GPIIb/IIIa inhibitors.
Dudek
Dariusz
D
2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University College of Medicine, Crakow, Poland. mcdudek@cyf-kr.edu.pl
Legutko
Jacek
J
Zymek
Paweł
P
Kałuza
Grzegorz L
GL
Dubiel
Jacek S
JS
D000368:Aged; D017130:Angioplasty / Q000379:methods*; D001161:Arteriosclerosis; D015331:Cohort Studies; D023903:Coronary Restenosis; D003331:Coronary Vessels / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D013997:Time Factors; D016896:Treatment Outcome