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Long-term Clinical outcomes with the use of a modified provisional Jailed-Balloon stenting technique for the treatment of non-left main coronary bifurcation lesions.
MedLine Citation:
PMID:  23420654     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives: To assess the long-term clinical outcomes associated with treatment of non-left main coronary bifurcation lesions using a modified provisional jailed-balloon technique (JBT). Background: Percutaneous coronary intervention (PCI) of bifurcation lesions is associated with a higher risk of adverse events, including the risk of side branch (SB) loss during main branch (MB) stenting. Methods: From 4/2003 to 8/2010, 406 patients with 424 non-left main coronary bifurcation lesions underwent PCI with (n = 95) and without (n = 311) the use of JBT. Rates of SB loss and long term clinical outcomes (death, myocardial infarction [MI], and target lesion revascularization [TLR]) were compared between patients undergoing PCI with and without JBT using univariate and propensity score adjusted and matched analyses. Results: The majority of patients presented with acute coronary syndrome (63%) and 90% of lesions were Medina class 1,1,1. Patients were followed for a mean of 2.7 ± 2.1 years. After propensity score matching (n = 81 in each group), JBT was associated with a significantly lower composite rate of death, MI, or TLR (HR 0.22, 95% CI 0.06-0.76; p = 0.02) and TLR (HR 0.20, 95% 0.04-0.92; p = 0.04) compared with no JBT. Permanent SB loss was significantly lower in the JBT group compared with no JBT group (OR 0.22, 95% CI 0.10-0.49; p = 0.0001). Conclusions: The use of JBT for the treatment of non-left main coronary bifurcation lesions was associated with significantly lower rates of SB loss and major adverse cardiac events at late follow-up. © 2012 Wiley Periodicals, Inc.
Authors:
Jeremiah P Depta; Yogesh Patel; Jayendrakumar S Patel; Eric Novak; Michael Yeung; Alan Zajarias; Howard I Kurz; John M Lasala; Richard G Bach; Jasvindar Singh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-19
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:  2013 Feb 
Date Detail:
Created Date:  2013-2-19     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:
Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
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