Document Detail

Three-year outcome of drug-eluting stent implantation for coronary artery bifurcation lesions.
MedLine Citation:
PMID:  19924774     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To compare the very long-term clinical outcomes of bifurcation lesions using the crush and the simultaneous kissing stent (SKS) techniques. BACKGROUND: A variety of two-stent techniques have been used to treat coronary artery bifurcation lesions in the drug-eluting stent era, but the long-term clinical outcome of these approaches is not known. METHODS: A total of 74 consecutive patients underwent bifurcation stenting using either the crush or SKS techniques. Mean patient age was 66.91 + or - 11.3 years; 26% were diabetic, and the left anterior descending/diagonal bifurcation was the most frequently treated lesion (68%). RESULTS: In-hospital outcomes were not significantly different between groups. Over a median follow-up of 3.3 years, 1 patient in the SKS group and 3 patients in the crush group died (P = ns). Probable stent thrombosis leading to death according to the Academic Research Consortium definition occurred in 1 patient in the crush group. Mortality in the remaining 3 patients was noncardiac. Target lesion revascularization (TLR) occurred in 14 patients (40%) in the SKS group and 5 patients (12.8%) in the crush group (P = 0.015). Survival free from major adverse cardiac events (MACE) was significantly less in the SKS group and predominantly driven by TLR (60 vs. 88%, P = 0.001). CONCLUSIONS: In conclusion, over a median of 3.3 years of follow-up, TLR and MACE are significantly lower in bifurcation lesions treated with the crush technique when compared with the SKS technique. Definite or probable stent thrombosis is rare with either technique.
Curtiss T Stinis; Stephen P C Hu; Matthew J Price; Paul S Teirstein
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  75     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-26     Completed Date:  2010-06-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  309-14     Citation Subset:  IM    
Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, CA 92037, USA.
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MeSH Terms
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Artery Disease / therapy*
Drug-Eluting Stents* / adverse effects
Immunosuppressive Agents / administration & dosage
Middle Aged
Prosthesis Implantation* / adverse effects
Sirolimus / administration & dosage
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Immunosuppressive Agents; 53123-88-9/Sirolimus
Comment In:
Catheter Cardiovasc Interv. 2010 Feb 15;75(3):315-6   [PMID:  20162695 ]

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

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