Balloon alignment T-stenting for bifurcation coronary artery disease using the sirolimus-eluting stent.
OBJECTIVE
The purpose of this study was to evaluate the long-term outcomes of bifurcation coronary lesions treated with a novel technique called "balloon alignment T-stenting".


BACKGROUND
The optimal technique for the treatment of bifurcation coronary disease has not yet been established.


METHODS
Twenty-six patients with bifurcation coronary lesions were treated with currently available drug-eluting stent (DES) platforms. This was a pilot study to determine the long-term efficacy of a novel technique, "balloon alignment T-stenting". Based on this technique we performed 6-month anniversary angiography to determine restenosis rates for both main and side branch lesions treated.


RESULTS
Twenty-six main branches and 27 side branches were treated with this novel technique. Angiographic 6-month follow up was available for all 26 patients treated. There were no postprocedural mortalities and no cases of postprocedural stent thrombosis during the follow-up period. At 6-month anniversary angiography, no evidence of main branch restenosis was seen. However, there were 2 cases of side branch restenosis for a total side branch restenosis rate of 7.4%. Target lesion revascularization for the 26 patients in the study was 7.6%. The total major adverse cardiac event rate for the group as a whole was 15.4%, with 2 periprocedural non-Q-wave myocardial infarctions and 2 target lesions requiring revascularization at 6 months.


CONCLUSIONS
Using currently available DES platforms, the data compiled from this small, single-center pilot study suggest that balloon alignment T-stenting may represent a reasonable approach for the treatment of bifurcation coronary artery disease. However, more comprehensive, larger-scale trials will be required to validate these preliminary findings.
Rizik
David G
DG
Scottsdale Heart Group at Scottsdale Healthcare Hospital, 9755 North 90th Street, A-100, Scottsdale, AZ 85259, USA. davidrizik@aol.com
Klassen
Kevin J
KJ
Dowler
Denise A
DA
Villegas
Bernard J
BJ
D000368:Aged; D003324:Coronary Artery Disease / Q000628:therapy*; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage* / Q000627:therapeutic use; D015607:Stents; D016896:Treatment Outcome
D020123:Sirolimus