Provisional TAP-stenting strategy to treat bifurcated lesions with drug-eluting stents: one-year clinical results of a prospective registry.
OBJECTIVE
To assess the clinical outcome of unselected patients undergoing drug-eluting stent (DES) implantation on bifurcated lesions using a "provisional T And small Protrusion (TAP)" stenting strategy.


METHODS
Consecutive patients undergoing DES implantation on one major bifurcation lesion were treated by main-vessel (MV) stenting, followed (if needed) by side-branch (SB) rewiring (with a "pullback" technique) and kissing balloon. SB stenting was performed according to the TAP-technique in selected cases. The endpoint of the study was a 12-month incidence of major adverse cardiac events (MACE) defined as cardiac death, myocardial infarction (MI), stent thrombosis and target vessel revascularization (TVR).


RESULTS
The study population included 266 patients (9% unprotected left main). Only 19 patients (7.1%) (with more complex angiographic features) received stents in both the MV and SB using the TAP-technique. Overall, 22 (8.2%) patients had MACE at 1 year. Observed, non-hierarchical MACE were: 1 (0.4%) cardiac death, 11 (4.1%) MI, 2 probable stent thromboses and 12 (4.5%) TVRs. Postprocedural troponin T increase and adverse events up to 12 months were similar between patients treated by MV stenting only or double stenting.


CONCLUSIONS
In unselected patients undergoing DES implantation on bifurcated lesions, a provisional TAP-stenting strategy (with a low rate of SB stenting) appears to be safe and effective.
Burzotta
Francesco
F
Institute of Cardiology, Catholic University of the Sacred Heart, Via Prati Fiscali 158, 00141 Rome, Italy. f.burzotta@rm.unicatt.it
Sgueglia
Gregory Angelo
GA
Trani
Carlo
C
Talarico
Giovanni Paolo
GP
Coroleu
Santiago Federico
SF
Giubilato
Simona
S
Niccoli
Giampaolo
G
Giammarinaro
Maura
M
Porto
Italo
I
Leone
Antonio Maria
AM
Mongiardo
Rocco
R
Mazzari
Mario Attilio
MA
Schiavoni
Giovanni
G
Crea
Filippo
F
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods*; D003324:Coronary Artery Disease / Q000145:classification* / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D013927:Thrombosis / Q000453:epidemiology; D016896:Treatment Outcome