Treatment of coronary bifurcation lesions by stent implantation only in parent vessel and angioplasty in sidebranch: immediate and long-term outcome.
The aim of this study was to evaluate the immediate and long-term outcome of intracoronary stent implantation for the treatment of bifurcation lesions. We treated 30 patients with bifurcation stenosis with the Bx Velocity stent implanted only in the parent vessel and with balloon angioplasty of the sidebranch. Angiographic success was 86.7% (n = 26 patients) in both branches and 100% in the main branch. Clinical success was achieved in 29 patients (96.7%). One patient (3.3%) suffered from a small non-Q wave myocardial infarction. All 30 patients underwent control coronary angiography at 6 months unless performed earlier due to symptoms. After the 6-month follow-up, a total of 27 patients (90%) were asymptomatic; angiographic restenosis (> 50%) was found in four cases (13.3%). There was no sidebranch restenosis. During the follow-up, one patient (3.3%) had unstable angina and angiography revealed severe diffuse restenosis within the whole stent; this patient was referred for coronary artery bypass surgery. Two patients had mild angina (Canadian Cardiovascular Society Class II) and 1 patient had silent ischemia during exercise stress test. These patients underwent repeat coronary angioplasty. The rate of major adverse cardiac events was 16.6% and target vessel revascularization rate was 13.3%. We concluded that stent implantation only in the parent vessel with angioplasty of the sidebranch in bifurcation lesions is safe and has a high clinical success rate and low rate of target lesion revascularization.
Cervinka
Pavel
P
Faculty Hospital Hradec Kralove, 2nd Department of Medicine, Czech Republic. cervinkap@iol.cz
Stasek
Joseph
J
Pleskot
Miloslav
M
Malý
Jaroslav
J
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome