title: Clinical and angiographic predictors of major side branch occlusion after main vessel stenting in coronary bifurcation lesions.
abstract: BACKGROUND
  Major side branch (SB) occlusion is one of the most serious complications during percutaneous coronary intervention (PCI) for bifurcation lesions. We aimed to characterize the incidence and predictors of major SB occlusion during coronary bifurcation intervention.
  
  
  METHODS
  We selected consecutive patients undergoing PCI (using one stent or provisional two stent strategy) for bifurcation lesions with major SB. All clinical characteristics, coronary angiography findings, PCI procedural factors and quantitative coronary angiographic analysis data were collected. Multivariate logistic regression analysis was performed to identify independent predictors of SB occlusion. SB occlusion after main vessel (MV) stenting was defined as no blood flow or any thrombolysis in myocardial infarction (TIMI) flow grade decrease in SB after MV stenting.
  
  
  RESULTS
  Among all 652 bifurcation lesions, 32 (4.91%) SBs occluded. No blood flow occurred in 18 lesions and TIMI flow grade decreasing occurred in 14 lesions. In multivariate analysis, diameter ratio between MV/SB (odds ratio [OR]: 7.71, 95% confidence interval [CI]: 1.53-38.85, P = 0.01), bifurcation angle (OR: 1.03, 95% CI: 1.02-1.05, P < 0.01), diameter stenosis of SB before MV stenting (OR: 1.05, 95% CI: 1.03-1.07, P < 0.01), TIMI flow grade of SB before MV stenting (OR: 3.59, 95% CI: 1.48-8.72, P < 0.01) and left ventricular eject fraction (LVEF) (OR: 1.06, 95% CI: 1.02-1.11, P < 0.01) were independent predictors of SB occlusion.
  
  
  CONCLUSIONS
  Among clinical and angiographic findings, diameter ratio between MV/SB, bifurcation angle, diameter stenosis of SB before MV stenting, TIMI flow grade of SB before MV stenting and LVEF were predictive of major SB occlusion after MV stenting.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhang
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.forename: Dong
authors.initials: D
authors.lastname: Yin
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Li
authors.forename: Yuan
authors.initials: Y
authors.lastname: He
authors.forename: Shi-Jie
authors.initials: SJ
authors.lastname: You
authors.forename: Shu-Bin
authors.initials: SB
authors.lastname: Qiao
authors.forename: Yong-Jian
authors.initials: YJ
authors.lastname: Wu
authors.forename: Hong-Bing
authors.initials: HB
authors.lastname: Yan
authors.forename: Yue-Jin
authors.initials: YJ
authors.lastname: Yang
authors.forename: Run-Lin
authors.initials: RL
authors.lastname: Gao
authors.affiliation: Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Cardiovascular Institute, Fuwai Hospital and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Ke-Fei
authors.initials: KF
authors.lastname: Dou
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods; D016896:Treatment Outcome