title: Percutaneous treatment of bifurcated lesions: a simple approach with a single bare metal R stent provides favourable long term clinical results.
abstract: OBJECTIVE
  Target lesion revascularization (TLR) rates of bifurcated lesions (BL) remain high, mainly due to side branch (SB) restenosis, even when drug-eluting stents (DES) are used. The aim of our study was to evaluate long-term clinical outcomes of a stepwise approach with single bare metal R stent implantation for BL.
  
  
  RESULTS
  In 465 patients, PCI was performed using a double guide wire, single stent in main branch (MB), and angioplasty of the SB, aiming at an optimal angiographic result of the MB and an optimal functional result (TIMI 3 flow) of the SB. 105 patients were treated for a true bifurcated lesion (TBL) and 360 patients were treated for a lesion with involvement of a significant side branch (ISB). Procedural success was achieved in all TBL and in 99% of ISB. At 1 year clinical follow-up, 8.6% treated for TBL had clinically driven TLR, 7.6% underwent repeat PCI, 1.0% underwent CABG. For patients treated for ISB, 13% had clinically driven TLR, 9.4% underwent repeat PCI, 3.6% CABG. 4 patients treated for TBL suffered non-fatal MI vs. 20 patients treated for ISB. Cardiac death occurred in 1.9% and 2.5 % respectively.
  
  
  CONCLUSIONS
  A simple approach in the percutaneous treatment of BL using a single bare metal R stent results in good 1 year clinical outcome comparable to the outcome reported following DES implantation.
authors.affiliation: Department of Cardiology - Academic Medical Centre - University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Marcel A M
authors.initials: MA
authors.lastname: Beijk
authors.forename: Saskia Z H
authors.initials: SZ
authors.lastname: Rittersma
authors.forename: Karel T
authors.initials: KT
authors.lastname: Koch
authors.forename: José P S
authors.initials: JP
authors.lastname: Henriques
authors.forename: Jan
authors.initials: J
authors.lastname: Baan
authors.forename: Rene J
authors.initials: RJ
authors.lastname: van der Schaaf
authors.forename: Mieke M
authors.initials: MM
authors.lastname: van Duinen
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter