Results of provisional stenting with a Sirolimus-eluting stent for bifurcation lesion: multicenter study in Japan.
BACKGROUND
Treatment of bifurcation lesion with a drug-eluting stent (DES) remains problematic. The purpose of this study was to investigate an appropriate treatment strategy for bifurcation lesion with a Sirolimus-eluting stent (SES).


METHODS
One-hundred-forty-one patients with 169 bifurcation lesions were treated at three centers in Japan using a Sirolimus-eluting stent. Forty-six lesions (39 patients) were treated on side branches, and provisional stenting was performed in these cases. We evaluated the angiographic results and clinical outcomes with this strategy. Patients with acute myocardial infarction were excluded.


RESULTS
After a follow-up period of 184 +/- 65 days, there were no deaths or myocardial infarction (MI), and only one (2.0%) target lesion revascularization (TLR). The strategies used for side-branch treatment were balloon only (83.7%) and T or Modified T stent (16.3%). The final kissing balloon technique was performed on 53.4% overall. In patients with a 6-month follow-up angiogram who had 25 bifurcation lesions (including 5 LMT bifurcation Lesions, 6 LCX-OM Lesions, 13 LAD-Dx lesions, and 1 RCA lesion) that were treated with balloon only, the percent diameter stenosis (%DS) of the side branch at follow-up was similar to that after the procedure (47.2 +/- 34.4% vs. 46.4 +/- 24.1%).


CONCLUSIONS
In the treatment of bifurcation lesions using a SES, the results of provisional stenting for the side branch are acceptable. Percent DS of the side branch remained unchanged over time after PCI.
Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.
Daizaburo
D
Yanagi
Kazuyuki
K
Shirai
Yosuke
Y
Takamiya
Yusuke
Y
Fukuda
Takashi
T
Kuwano
Amane
A
Ike
Ken
K
Mori
Kazumitsu
K
Kubota
Atsushi
A
Iwata
Kanta
K
Fujimi
Akira
A
Kawamura
Hiroaki
H
Nishikawa
Nathan
N
Miller
Bo
B
Zhang
Yoshihiro
Y
Tsuchiya
Hidenori
H
Urata
Keijiro
K
Saku
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
D020123:Sirolimus