title: Randomized study on simple versus complex stenting of coronary artery bifurcation lesions: the Nordic bifurcation study.
abstract: BACKGROUND
  The optimal stenting strategy in coronary artery bifurcation lesions is unknown. In the present study, a strategy of stenting both the main vessel and the side branch (MV+SB) was compared with a strategy of stenting the main vessel only, with optional stenting of the side branch (MV), with sirolimus-eluting stents.
  
  
  RESULTS
  A total of 413 patients with a bifurcation lesion were randomized. The primary end point was a major adverse cardiac event: cardiac death, myocardial infarction, target-vessel revascularization, or stent thrombosis after 6 months. At 6 months, there were no significant differences in rates of major adverse cardiac events between the groups (MV+SB 3.4%, MV 2.9%; P=NS). In the MV+SB group, there were significantly longer procedure and fluoroscopy times, higher contrast volumes, and higher rates of procedure-related increases in biomarkers of myocardial injury. A total of 307 patients had a quantitative coronary assessment at the index procedure and after 8 months. The combined angiographic end point of diameter stenosis >50% of main vessel and occlusion of the side branch after 8 months was found in 5.3% in the MV group and 5.1% in the MV+SB group (P=NS).
  
  
  CONCLUSIONS
  Independent of stenting strategy, excellent clinical and angiographic results were obtained with percutaneous treatment of de novo coronary artery bifurcation lesions with sirolimus-eluting stents. The simple stenting strategy used in the MV group was associated with reduced procedure and fluoroscopy times and lower rates of procedure-related biomarker elevation. Therefore, this strategy can be recommended as the routine bifurcation stenting technique.
authors.affiliation: Department of Cardiology, University Hospital of Tromsoe, Tromsoe, Norway.
authors.forename: Terje K
authors.initials: TK
authors.lastname: Steigen
authors.forename: Michael
authors.initials: M
authors.lastname: Maeng
authors.forename: Rune
authors.initials: R
authors.lastname: Wiseth
authors.forename: Andrejs
authors.initials: A
authors.lastname: Erglis
authors.forename: Indulis
authors.initials: I
authors.lastname: Kumsars
authors.forename: Inga
authors.initials: I
authors.lastname: Narbute
authors.forename: Pål
authors.initials: P
authors.lastname: Gunnes
authors.forename: Jan
authors.initials: J
authors.lastname: Mannsverk
authors.forename: Oliver
authors.initials: O
authors.lastname: Meyerdierks
authors.forename: Svein
authors.initials: S
authors.lastname: Rotevatn
authors.forename: Matti
authors.initials: M
authors.lastname: Niemelä
authors.forename: Kari
authors.initials: K
authors.lastname: Kervinen
authors.forename: Jan S
authors.initials: JS
authors.lastname: Jensen
authors.forename: Anders
authors.initials: A
authors.lastname: Galløe
authors.forename: Kjell
authors.initials: K
authors.lastname: Nikus
authors.forename: Saila
authors.initials: S
authors.lastname: Vikman
authors.forename: Jan
authors.initials: J
authors.lastname: Ravkilde
authors.forename: Stefan
authors.initials: S
authors.lastname: James
authors.forename: Jens
authors.initials: J
authors.lastname: Aarøe
authors.forename: Antti
authors.initials: A
authors.lastname: Ylitalo
authors.forename: Steffen
authors.initials: S
authors.lastname: Helqvist
authors.forename: Iwar
authors.initials: I
authors.lastname: Sjögren
authors.forename: Per
authors.initials: P
authors.lastname: Thayssen
authors.forename: Kari
authors.initials: K
authors.lastname: Virtanen
authors.forename: Mikko
authors.initials: M
authors.lastname: Puhakka
authors.forename: Juhani
authors.initials: J
authors.lastname: Airaksinen
authors.forename: Jens F
authors.initials: JF
authors.lastname: Lassen
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
mesh_terms: D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage / Q000627:therapeutic use; D015607:Stents; D016896:Treatment Outcome
chemical_list: D020123:Sirolimus