title: Culotte versus T-stenting in bifurcation lesions: immediate clinical and angiographic results and midterm clinical follow-up.
abstract: BACKGROUND
  Stenting the main vessel with provisional stenting of the side branch (SB) is the method of choice for most bifurcation lesions. There is limited data on which of the two techniques of bifurcation stenting compatible with a provisional approach, culotte or T-stenting, offers the best outcome.
  
  
  METHODS
  Between February 2004 and October 2005, 80 consecutive patients with bifurcation lesions requiring a second stent on the SB were treated with either culotte (n = 45) or T-stenting (n = 35). Coronary angiograms were analyzed using a quantitative angiography system dedicated to bifurcations. Propensity scores were used to adjust for baseline differences between groups.
  
  
  RESULTS
  Acute procedural success was 100% for both groups. Residual diameter stenosis of the SB ostium was 3.44% +/- 7.39% in the culotte group versus 12.55% +/- 11.47% in the T-stenting group (P < .0001). One patient (2.2%) in the culotte group had subacute thrombosis 2 days after the procedure. The culotte group had a lower target lesion revascularization rate compared with the T-stenting group (8.9% vs 27.3% propensity score adjusted; P = .014) and a trend toward lower major cardiac adverse events at 9 months (13.3% vs 27.3%; P = .051).
  
  
  CONCLUSIONS
  Both techniques of provisional SB stenting in bifurcation lesions achieve high procedural success with low complication rates. The culotte technique yields a better immediate angiographic result at the SB ostium, and, using drug-eluting stents, a better clinical outcome at 9 months.
authors.affiliation: Royal Brompton Hospital, London, United Kingdom.
authors.forename: Sahin
authors.initials: S
authors.lastname: Kaplan
authors.forename: Peter
authors.initials: P
authors.lastname: Barlis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Dimopoulos
authors.forename: Alessio
authors.initials: A
authors.lastname: La Manna
authors.forename: Omer
authors.initials: O
authors.lastname: Goktekin
authors.forename: Alfredo
authors.initials: A
authors.lastname: Galassi
authors.forename: Jun
authors.initials: J
authors.lastname: Tanigawa
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000188:drug therapy / Q000628:therapy*; D016503:Drug Delivery Systems; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents
chemical_list: D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus