Document Detail


Comparing two-stent strategies for bifurcation coronary lesions: which vessel should be stented first, the main vessel or the side branch?
MedLine Citation:
PMID:  21860553     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study compared two-stent strategies for treatment of bifurcation lesions by stenting order, 'main across side first (A-family)' vs 'side branch first (S-family). The study population was patients from 16 centers in Korea who underwent drug eluting stent implantation with two-stent strategy (A-family:109, S-family:140 patients). The endpoints were cardiac death, myocardial infarction (MI), stent thrombosis (ST), and target lesion revascularization (TLR) during 3 years. During 440.8 person-years (median 20.2 months), there was 1 cardiac death, 4 MIs (including 2 STs), and 12 TLRs. Cumulative incidence of cardiac death, MI and ST was lower in A-family (0% in A-family vs 4.9% in S-family, P = 0.045). However, TLR rates were not different between the two groups (7.1% vs 6.2%, P = 0.682). Final kissing inflation (FKI) was a predictor of the hard-endpoint (hazard ratio 0.061; 95% CI 0.007-0.547, P = 0.013), but was not a predictor of TLR. The incidence of hard-endpoint of S-family with FKI was comparable to A-family, whereas S-family without FKI showed the poorest prognosis (1.1% vs 15.9%, retrospectively; P = 0.011). In conclusion, 'A-family' seems preferable to 'S-family' if both approaches are feasible. When two-stent strategy is used, every effort should be made to perform FKI, especially in 'S-family'.
Authors:
Dong-Ho Shin; Kyung Woo Park; Bon-Kwon Koo; Il-Young Oh; Jae-Bin Seo; Hyeon-Cheol Gwon; Myung-Ho Jeong; In-Whan Seong; Seung Woon Rha; Ju-Young Yang; Seung-Jung Park; Jung Han Yoon; Kyoo-Rok Han; Jong-Sun Park; Seung-Ho Hur; Seung-Jea Tahk; Hyo-Soo Kim
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-07-27
Journal Detail:
Title:  Journal of Korean medical science     Volume:  26     ISSN:  1598-6357     ISO Abbreviation:  J. Korean Med. Sci.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-23     Completed Date:  2011-12-12     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  8703518     Medline TA:  J Korean Med Sci     Country:  Korea (South)    
Other Details:
Languages:  eng     Pagination:  1031-40     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / methods*
Coronary Stenosis / surgery,  therapy*
Death, Sudden, Cardiac / etiology
Drug-Eluting Stents*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / etiology
Myocardial Revascularization
Thrombosis / etiology
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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