Document Detail


Intravascular ultrasound-guided systematic two-stent techniques for coronary bifurcation lesions and reduced late stent thrombosis.
MedLine Citation:
PMID:  22899562     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The effects of intravascular ultrasound (IVUS)-guided complex approaches using drug-eluting stents (DES) for coronary bifurcation lesions on clinical outcomes has not yet been studied in detail. OBJECTIVE: Our objective was to analyze the difference in one-year outcomes following two-stent techniques involving implantation of DES for coronary bifurcation lesions between IVUS-guided and angiography-guided groups. METHODS: From May 26, 2007 to March 24, 2010, 628 patients received two-stent techniques (324 in the IVUS-guided group and 304 angiography-guided) and were prospectively studied. We compared major adverse cardiac events (MACE, including cardiac death, stent thrombosis [ST], myocardial infarction [MI] and target lesion/vessel revascularization) at 12-months follow-up, before and after adjusting for propensity score matching. RESULTS: At 12-months after the indexed procedure, patients in the angiography-guided group had significantly increased in-stent restenosis. Compared to the angiography-guided group, the IVUS-guided group had a significantly lower overall unadjusted ST rate (1.2% vs. 6.9%, p<0.001), definite ST (0.6% vs. 5.3%, p<0.001), late ST (0.6% vs. 4.3%, p=0.003), MI (4.6% vs. 8.9%, p=0.038) and cardiac death (0.9% vs. 3.3%, p=0.049). By propensity score matching, 123 paired patients were matched. The late ST at 12-months follow-up was 0% in the IVUS-guided group vs. 4.9% in the angiography-guided group (p=0.029), resulting in significant differences in ST-elevation MI between the two groups (2.4% vs. 9.8%, p=0.030). CONCLUSIONS: The IVUS-guided two-stent technique was associated with significantly reduced late stent thrombosis, with a resultant reduction in ST-elevation MI. © 2012 Wiley Periodicals, Inc.
Authors:
Shao-Liang Chen; Fei Ye; Jun-Jie Zhang; Nai-Liang Tian; Zhi-Zhong Liu; Teguh Santoso; Yu-Jie Zhou; Tie-Ming Jiang; Shang-Yu Wen; Tak W Kwan
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-17
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
Nanjing First Hospital, Nanjing Medical University, Nanjing, China. chmengx@126.com.
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