title: The long-term clinical outcome of T-stenting and small protrusion technique for coronary bifurcation lesions.
abstract: OBJECTIVE
  This study sought to report long-term clinical outcomes in patients treated with the provisional T-stenting and small protrusion (TAP) technique.
  
  
  BACKGROUND
  Several strategies have been proposed for treating bifurcation lesions, each with its own merits and technical challenges. The TAP technique is a relatively new strategy that is technically less challenging, ensures complete coverage of the side-branch ostium, and minimizes stent overlap. Although there is reasonable amount of data for other bifurcation strategies, the long-term clinical outcomes for TAP technique are limited.
  
  
  METHODS
  We retrospectively evaluated all patients who underwent TAP technique with drug-eluting stents between July 2005 and January 2012. The measured endpoints at follow-up were major adverse cardiac events defined as composite of cardiac death, myocardial infarction, and target vessel revascularization.
  
  
  RESULTS
  A total of 95 patients (81.1% men) with a mean age of 64.8 years underwent TAP stenting. Procedural success was achieved in 100% of cases. True bifurcation was observed in 75 (78.9%) patients. First-generation drug-eluting stents were used in 55.8% of patients. The outcome rates at 3-year follow-up of major adverse cardiac events, cardiac death/follow-up myocardial infarction, target vessel revascularization, and target lesion revascularization were 12.9%, 3.1%, 9.7%, and 5.1%, respectively. There were no cases of follow-up myocardial infarction or stent thrombosis (definite and probable).
  
  
  CONCLUSIONS
  These results demonstrate that TAP technique is associated with acceptable clinical outcomes with no episodes of definite and probable stent thrombosis. Further studies should compare TAP technique with other 2-stent strategies.
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Toru
authors.initials: T
authors.lastname: Naganuma
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.forename: Sandeep
authors.initials: S
authors.lastname: Basavarajaiah
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.forename: Filippo
authors.initials: F
authors.lastname: Figini
authors.forename: Mauro
authors.initials: M
authors.lastname: Carlino
authors.forename: Matteo
authors.initials: M
authors.lastname: Montorfano
authors.forename: Cosmo
authors.initials: C
authors.lastname: Godino
authors.forename: Santo
authors.initials: S
authors.lastname: Ferrarello
authors.forename: Tasuku
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Sunao
authors.initials: S
authors.lastname: Nakamura
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods* / Q000401:mortality; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional