title: Impact of bifurcation stent technique on clinical outcomes in patients with a Medina 0,0,1 coronary bifurcation lesion: results from the COBIS (COronary BIfurcation Stenting) II registry.
abstract: OBJECTIVE
  To compare the long-term clinical outcomes of patients treated with 1- versus 2-stent techniques for Medina 0,0,1 type bifurcation lesions.
  
  
  BACKGROUND
  Little is known about clinical outcomes and optimal treatment strategies for Medina 0,0,1 type bifurcation lesions
  
  
  METHODS
  A total of 2,897 consecutive patients who underwent percutaneous coronary intervention using a drug-eluting stent for a coronary bifurcation lesion with a side branch (SB) ≥2.3 mm were enrolled from 18 centers in South Korea. We compared target lesion failure (TLF), defined as the composite of cardiac death, myocardial infarction, or target lesion revascularization (TLR) according to 1- or 2-stent techniques in the patients with a de novo Medina 0,0,1 type bifurcation lesion (n = 113, 3.9%)
  
  
  RESULTS
  Fifty patients were treated with the 1-stent technique, and 63 patients with the 2-stent technique. During a median follow-up duration of 36.6 months, patients in the 1-stent technique group tended to have a higher incidence of TLR (3.2 versus 12.0%, P = 0.07) and TLF (4.8 versus 12.0%, P = 0.16) than those in the 2-stent technique group. Multivariate analysis revealed that the 1-stent technique was associated with a higher risk of TLR (hazard ratio [HR] 7.35; 95% confidence interval [CI] 1.27-42.5; P = 0.03) and TLF (HR 4.65; 95% CI 1.01-21.6; P = 0.05) than the 2-stent technique
  
  
  CONCLUSIONS
  In patients with a Medina 0,0,1 type bifurcation lesion, the 2-stent technique seems to be associated with a better clinical outcome compared with the 1-stent technique. These findings need to be confirmed in randomized controlled trials.
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Jang
authors.forename: Young Bin
authors.initials: YB
authors.lastname: Song
authors.forename: Joo-Yong
authors.initials: JY
authors.lastname: Hahn
authors.forename: Seung-Hyuk
authors.initials: SH
authors.lastname: Choi
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Cheol Woong
authors.initials: CW
authors.lastname: Yu
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012042:Registries; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome
keywords: drug-eluting stent; medina 0,0,1 lesion; percutaneous coronary intervention; stent technique