Document Detail


Long-term outcomes of bifurcation lesions after implantation of drug-eluting stents with the "mini-crush technique".
MedLine Citation:
PMID:  17295334     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate clinical and angiographic long-term outcome of "the mini-crush" technique for treating bifurcation lesions. BACKGROUND: Despite proven efficacy of drug-eluting stent (DES) within most lesions subsets, bifurcation lesions continue to exhibit high restenosis rate using current DES stenting technique. METHODS: We report a new stenting technique which was employed in 45 consecutive patients (52 lesions) between April 2004 and July 2005 to treat true bifurcation lesions using DES in both branches. RESULTS: Using this technique procedural success was obtained in 100% of cases, without complications and with excellent angiographic result in 96.1% and 98.1% of main vessel and side branch. Preprocedure reference vessel diameter and minimal lumen diameter (MLD) were 2.68 +/- 0.48 and 0.90 +/- 0.55 mm for the main branch, respectively and 2.28 +/- 0.34 and 1.14 +/- 0.47 mm for the side branch, respectively. Postprocedure MLD was 2.56 +/- 0.39 mm for the main branch and 2.16 +/- 0.29 mm for the side branch. There were no in-hospital major adverse cardiac events (MACE). At 72 days after procedure there was one case of side branch stent thrombosis (2.2%), which resulted in non Q-wave MI. Angiographic follow up was obtained in 100% of patients at 7.5 +/- 1.3 months. Target lesion revascularization (TLR) was 12.2%; no death and Q-wave MI were observed; reference vessel diameter and MLD for the main branch were 2.79 +/- 0.51 and 1.99 +/- 0.65 mm respectively and for the side branch 2.28 +/- 0.40 and 1.63 +/- 0.48 mm respectively. Restenosis rate in the main branch was 12.2% while in the side branch was 2.0%. CONCLUSIONS: In-hospital outcome indicates that the mini-crush technique for bifurcation lesions with DES can be easily performed. It provides very low total MACE rate and restenosis at 8-month follow-up. These results confirmed the advantage of this specific technique to give complete coverage of the ostium of the side branch using two stents technique.
Authors:
Alfredo R Galassi; Antonio Colombo; Maurice Buchbinder; Carmelo Grasso; Salvatore D Tomasello; Gian P Ussia; Corrado Tamburino
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  69     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-31     Completed Date:  2007-07-13     Revised Date:  2008-05-29    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  976-83     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine and Systemic Disease, Clinical Division of Cardiology, Ferrarotto Hospital, University of Catania, Italy. jimmanh2002@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  methods*
Cardiovascular Agents / administration & dosage,  therapeutic use*
Coronary Angiography
Coronary Artery Disease / drug therapy,  pathology,  therapy*
Coronary Restenosis / etiology,  prevention & control
Databases as Topic
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / etiology,  prevention & control
Paclitaxel / administration & dosage,  therapeutic use*
Pilot Projects
Prospective Studies
Prosthesis Design
Sirolimus / administration & dosage,  therapeutic use*
Stents*
Thrombosis / complications,  etiology,  prevention & control
Time Factors
Treatment Outcome
Ultrasonography, Interventional
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2008 May 1;71(6):E7-8   [PMID:  18412092 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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