Document Detail

In-hospital and nine-month outcomes among patients with coronary lesions involving a side branch and treated with bare metal stents.
MedLine Citation:
PMID:  20506118     Owner:  NLM     Status:  In-Process    
BACKGROUND: The optimal management of coronary lesions involving side branches is not known. New devices are being developed for dedicated bifurcation stenting or improved side branch access or protection. Several of these devices are bare-metal stent (BMS) platforms. The risk of side branch compromise and outcome after standard BMS is not known.
METHODS: We evaluated the frequency of side branch involvement and the rate of side branch compromise in a retrospective analysis of 1,440 patients from three pooled historical BMS clinical trials. The impact of side branch compromise on in-hospital and nine-month clinical outcomes was assessed.
RESULTS: Side branches >2 mm in diameter were present within the stented segment in 39% of treated lesions. Compromise of a side branch occurred in 27% of 1,440 lesions, including 22% of side branches that were not diseased prior to stenting. Compromise was associated with increased in-hospital MI (13.5% vs. 7.6%, P = 0.001), a trend for increased nine-month clinically driven target vessel revascularization (TVR, 17.4% vs. 13.2%, P = 0.058), and increased nine-month target vessel failure (composite of cardiac death, target vessel MI or TVR, 29.7% vs. 20.2%, P < 0.001).
CONCLUSION: At least moderate-sized side branches are involved frequently in lesions enrolled in routine clinical trials. Unexpected compromise of these side branches is common and is associated with increased in-hospital and nine-month adverse outcomes.
Victor Novack; Lisa Battaglia; Jeffrey J Popma; Donald E Cutlip
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  76     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  951-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Wiley-Liss, Inc.
Harvard Clinical Research Institute, Boston, Massachusetts, USA.
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MeSH Terms
Comment In:
Catheter Cardiovasc Interv. 2010 Dec 1;76(7):958-9   [PMID:  21108372 ]

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