title: Long-term outcome of simultaneous kissing stenting technique with sirolimus-eluting stent for large bifurcation coronary lesions.
abstract: OBJECTIVE
  This study was conducted to evaluate the outcomes of simultaneous kissing stenting with sirolimus-eluting stent (SES).
  
  
  BACKGROUND
  Percutaneous intervention for bifurcation coronary lesions is still challenging.
  
  
  METHODS
  This study was designed to evaluate the long-term outcomes of 36 consecutive patients with large bifurcation coronary lesions who underwent simultaneous kissing stenting with SES.
  
  
  RESULTS
  Lesion location was unprotected left main in 29 patients (81%) and anterior descending artery in 7 (19%). The patients received a combination of aspirin and clopidogrel for 6 months and cilostazol for 1 month. Mean proximal reference diameter was 4.05 +/- 0.68 mm. Compared with the side branch (SB), the main vessel (MV) involved longer lesions (25.8 +/- 17.0 mm vs. 10.2 +/- 10.8 mm, P < 0.001) and smaller preprocedural minimal lumen diameters (1.02 +/- 0.53 mm vs. 1.46 +/- 0.78 mm, P = 0.006) and was treated with larger stents (3.1 +/- 0.3 mm vs. 3.0 +/- 0.3 mm, P = 0.006). Angiographic success rate was 100%. Over the follow-up of 26.7 +/- 8.6 months, no deaths, myocardial infarctions or stent thromboses occurred. Target lesion revascularization was performed in five patients (14%). Overall angiographic restenosis occurred in 5/30 patients (17%), consisting of 4 (13%) at MV and 3 (10%) at SB. At follow-up angiography, a membranous diaphragm at the carina was identified in 14 patients (47%), but only one of whom was associated with angiographic restenosis.
  
  
  CONCLUSIONS
  Simultaneous kissing stenting with SES appears a feasible stenting technique in large bifurcation coronary lesions. However, a new angiographic structure of carinal membrane developed in a half of patients at follow-up and its influence needs to be further investigated.
authors.affiliation: Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.forename: Duk-Woo
authors.initials: DW
authors.lastname: Park
authors.forename: Il-Woo
authors.initials: IW
authors.lastname: Suh
authors.forename: Jae-Sik
authors.initials: JS
authors.lastname: Jang
authors.forename: Eui-Seock
authors.initials: ES
authors.lastname: Hwang
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Jeong
authors.forename: Se-Whan
authors.initials: SW
authors.lastname: Lee
authors.forename: Seung-Whan
authors.initials: SW
authors.lastname: Lee
authors.forename: Cheol Whan
authors.initials: CW
authors.lastname: Lee
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
authors.forename: Jae-Joong
authors.initials: JJ
authors.lastname: Kim
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000453:epidemiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome