title: Angiographic and long-term clinical outcome of the sleeve technique in treating in-stent restenotic bifurcation lesions: a preliminary experience.
abstract: BACKGROUND
  No data has been published on the management of in-stent restenotic bifurcation lesions. The aim of this small case series was to examine the angiographic and long-term clinical outcomes of using sleeve technique to treat this lesion subset.
  
  
  METHODS
  Six consecutive and symptomatic patients with MEDINA classification 1,1,1 in-stent restenotic bifurcation lesion were treated with drug-eluting stents using sleeve technique. Dual antiplatelet therapy was prescribed for an average of 13.5 ± 2.3 months.
  
  
  RESULTS
  Most of the lesions (87%) were located at LAD/diagonal branch bifurcation. Kissing balloon inflation was performed successfully in all the patients. Follow-up angiography at nine months revealed a late loss of 0.35 ± 0.26 mm and 0.56 ± 0.56 mm in MV and SB, respectively. Angiographic restenosis was developed in 2 patients (33%), which were all located at the SB ostium. No in-hospital MACE was observed. One-year MACE was 17%, attributed by 1 patient with restenosis who needed revascularization. The mean follow up period was 50 ± 18 months, no stent thrombosis was detected.
  
  
  CONCLUSIONS
  The use of sleeve technique to treat in-stent restenotic bifurcation lesions is associated with good acute procedural result, a fairly low one-year MACE and long-term clinical safety.
authors: Cardiac Medical Unit, Grantham Hospital, Hong Kong. jimmanh2002@yahoo.com
authors: Man-Hong
authors: MH
authors: Jim
authors: Hee-Hwa
authors: HH
authors: Ho
authors: Kai-Hang
authors: KH
authors: Yiu
authors: Chung-Wah
authors: CW
authors: Siu
authors: Wing-Hing
authors: WH
authors: Chow
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023903:Coronary Restenosis; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D054855:Drug-Eluting Stents; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome