title: Assessment of side branch predilation before a provisional T-stent strategy for bifurcation lesions. A randomized trial.
abstract: BACKGROUND
  A simple approach is the predominant strategy for the percutaneous coronary intervention of bifurcation lesions. Performing side branch (SB) predilation in this context is currently a matter of controversy. In this study, we assess the efficacy of SB predilatation before a provisional T-stent strategy for bifurcation lesions.
  
  
  METHODS
  Between February 2009 and November 2012, 372 patients with true bifurcation lesions were randomized to either predilation of the SB (n = 187) or no predilatation (n = 185) before main branch (MB) stent implantation and a subsequent SB provisional stent strategy.
  
  
  RESULTS
  There were no significant differences between the patient groups regarding the baseline characteristics. After MB stent implantation, the TIMI flow of the SB was higher in the patients with SB predilation: TIMI flow 0 to 1; 2 (1%) versus 18 (10%), P < .001; and TIMI flow III; 179 (96%) versus 152 (82%), P < .001. Side branch stenting rates were 4% versus 3%, P = not significant. In addition, 60 patients (32%) from the SB predilation group presented SB residual stenosis by visual inspection <50%, and TIMI flow ≥III did not require any additional treatment. The failure rate of SB rewiring, the time of rewiring, the number of wires used, and the incidence of major events were similar in both groups of patients.
  
  
  CONCLUSIONS
  Predilation of the SB resulted in improved TIMI flow after MB stenting and less indication to subsequently treat the SB. If rewiring of the SB is required, predilation did not hinder this maneuver.
authors.affiliation: Reina Sofia Hospital, Department of Cardiology, University of Córdoba (IMIBIC), Avenida Melendez Pidal 1, Cordoba, Spain. Electronic address: manuelpan@telefonica.net.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.affiliation: Dr Negrin Hospital, Department of Cardiology, University of Las Palmas, Las Palmas de Gran Canaria, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Medina
authors.affiliation: Reina Sofia Hospital, Department of Cardiology, University of Córdoba (IMIBIC), Avenida Melendez Pidal 1, Cordoba, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Romero
authors.affiliation: Reina Sofia Hospital, Department of Cardiology, University of Córdoba (IMIBIC), Avenida Melendez Pidal 1, Cordoba, Spain.
authors.forename: Soledad
authors.initials: S
authors.lastname: Ojeda
authors.affiliation: Dr Negrin Hospital, Department of Cardiology, University of Las Palmas, Las Palmas de Gran Canaria, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Martin
authors.affiliation: Reina Sofia Hospital, Department of Cardiology, University of Córdoba (IMIBIC), Avenida Melendez Pidal 1, Cordoba, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Suarez de Lezo
authors.affiliation: Reina Sofia Hospital, Department of Cardiology, University of Córdoba (IMIBIC), Avenida Melendez Pidal 1, Cordoba, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Segura
authors.affiliation: Reina Sofia Hospital, Department of Cardiology, University of Córdoba (IMIBIC), Avenida Melendez Pidal 1, Cordoba, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Mazuelos
authors.affiliation: Dr Negrin Hospital, Department of Cardiology, University of Las Palmas, Las Palmas de Gran Canaria, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Novoa
authors.affiliation: Reina Sofia Hospital, Department of Cardiology, University of Córdoba (IMIBIC), Avenida Melendez Pidal 1, Cordoba, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Suarez de Lezo
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000628:therapy*; D004106:Dilatation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow; D016037:Single-Blind Method; D015607:Stents