title: Natural history of side branches jailed by drug-eluting stents.
abstract: BACKGROUND
  Stent deployment across side branch (SB) ostium is common in daily practice. The present study investigated the natural history of SBs jailed by drug-eluting stents (DES).
  
  
  METHODS
  The thrombolysis in myocardial infarction (TIMI) flow grades of 271 consecutive SBs jailed by DES in 196 patients was assessed immediately after the procedure and at 9 months of follow-up. Patients receiving any SB intervention were excluded.
  
  
  RESULTS
  Of 271 jailed SBs, occlusion occurred in 6.27% and deterioration of flow occurred in 6.27% immediately after stenting. In patients with these SB changes, periprocedural myocardial infarction was more likely than in those without (10.0% vs. 1.8%, P = 0.017), while there was no increase of cardiac death or life-threatening complications such as stent thrombosis and Q-wave myocardial infarction (Q MI) during follow-up. At 9 months, angiography showed that one-third of the initially obstructed SBs were still occluded. In contrast, flow was maintained in almost all (98.6%) SBs with early TIMI flow grade 3 and there was no delayed occlusion of these branches. Multiple regression analysis showed that lesion complexity (Medina bifurcation class, calcification, and preprocedural TIMI grade 2 flow in the SB) and technical factors (jailing by overlapping stents) were related to SB occlusion or flow deterioration.
  
  
  CONCLUSIONS
  Jailed SBs showing good flow after stenting had a favorable angiographic and clinical outcome after 9 months of follow-up. However, preprocedural lesion complexity and technical factors should be considered to avoid SB occlusion/flow deterioration associated with periprocedural myocardial infarction.
authors: Division of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan. m_yamawaki@tobu.saiseikai.or.jp
authors: Masahiro
authors: M
authors: Yamawaki
authors: Toshiya
authors: T
authors: Muramatsu
authors: Motoharu
authors: M
authors: Araki
authors: Keisuke
authors: K
authors: Hirano
authors: Masatsugu
authors: M
authors: Nakano
authors: Hiroshi
authors: H
authors: Ishimori
authors: Yoshiaki
authors: Y
authors: Ito
authors: Yoshinobu
authors: Y
authors: Murasato
authors: Takafumi
authors: T
authors: Ueno
authors: Reiko
authors: R
authors: Tsukahara
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods*; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D061185:Mechanical Thrombolysis; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome