title: Angiographic study of the clinical liaison of drug-eluting stent and paclitaxel-eluting balloon in unifocal side branch ostium stenosis (ASCLEPIUS).
abstract: A reliable stenting strategy for treating isolated side branch (SB) ostium stenosis is not well established. The purpose of this study was to examine the 6-month angiographic outcome of a novel technique, called the shoulder technique, on this lesion subtype. Symptomatic patients with isolated SB ostium stenosis, defined as ≥75% diameter stenosis at SB ostium and <50% diameter stenosis in main vessel (MV), were treated with paclitaxel-eluting balloon in MV and drug-eluting stent in SB using the shoulder technique. Angiographic restudy was performed at 5-9 months and clinical follow-up was scheduled regularly every 3 months. There were 46 patients of age 66 ± 12 years with male predominance (76%) recruited. Diagonal ostium (67%) was the most frequent target lesion site. The size and length of paclitaxel-eluting balloon and drug-eluting stent used in MV and SB were 3.01 ± 0.25 and 20 ± 4 mm, and 2.39 ± 0.25 and 17 ± 6 mm, respectively. Angiographic restudy was performed on 43 (93.5%) patients at 6.5 ± 1.6 months. The late loss in MV and SB were 0.04 ± 0.19 and 0.19 ± 0.32 mm, respectively. Angiographic restensosis was seen in 2 (4.7%) patients at SB, whereas no stenosis was induced in MV. Improvement of symptom was reported in 36 (78%) patients. At 1-year follow-up, no death, myocardial infarction, and stent thrombosis was observed; target vessel revascularization was performed on 3 (6.5%) patients. Treatment of isolated SB ostium stenosis using the shoulder technique is associated with a favorable short-term angiographic outcome.
authors.affiliation: Cardiac Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Road, Hong Kong, Hong Kong. jimmanh2002@yahoo.com.
authors.forename: Man-Hong
authors.identifier: http://orcid.org/0000-0003-1202-0503
authors.initials: MH
authors.lastname: Jim
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, Hong Kong.
authors.forename: Eugene Brian
authors.initials: EB
authors.lastname: Wu
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, Hong Kong.
authors.forename: Chi-Yuen
authors.initials: CY
authors.lastname: Chan
authors.affiliation: Cardiac Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Road, Hong Kong, Hong Kong.
authors.forename: Ka-Lam
authors.initials: KL
authors.lastname: Wong
authors.affiliation: Cardiac Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Road, Hong Kong, Hong Kong.
authors.forename: Raymond Chi-Yan
authors.initials: RC
authors.lastname: Fung
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong, Hong Kong.
authors.forename: Kai-Hang
authors.initials: KH
authors.lastname: Yiu
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D000972:Antineoplastic Agents, Phytogenic / Q000494:pharmacology; D017023:Coronary Angiography / Q000379:methods*; D023903:Coronary Restenosis / Q000517:prevention & control; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000494:pharmacology*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011474:Prosthesis Design; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel
keywords: Bifurcation stenosis; Drug-eluting stent; Isolated side branch ostium stenosis; Paclitaxel-eluting balloon; Percutaneous coronary intervention; Restenosis