Document Detail


Treatment of true bifurcation stenosis by elective stent implantation in parent vessel and non-stent dilatation of side branch: immediate and follow-up results.
MedLine Citation:
PMID:  10976149     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Data of 67 consecutive patients who underwent stent implantation in the parent vessel and non-stent dilatation of the side branch of a true bifurcation stenosis was retrospectively analysed. The mean age was 53.2 +/- 9.7 years, with majority (89.6%) being males. Forty-seven (70.1%) lesions involved the bifurcation of left anterior descending artery and its major diagonal branch. The parent vessel was treated using balloon angioplasty in 50 (74.6%), rotational atherectomy in 15 (22.4%) and directional coronary atherectomy in 2 (3.0%) patients. All the patients subsequently received an intracoronary stent in the parent vessel. Depending upon the treatment strategy for the side branch, the patients were divided into two groups: (1) Percutaneous transluminal coronary angioplasty group, which included 37 patients in whom the side branch was dilated by plain balloon angioplasty, and (2) Debulking group, in which 30 patients underwent debulking of the side branch using rotablation or directional coronary atherectomy. Overall, the procedure was successful in 64 (95.6%) patients. One (1.5%) patient developed non-Q wave myocardial infarction during the hospital stay. There were no Q-wave myocardial infarction, need for emergency coronary artery bypass surgery or death. Clinical follow-up of at least six months was available in all patients with a mean duration of 9.5 +/- 3.2 months. Recurrence of symptoms developed in 19 (28.4%) patients. Fourteen (20.9%) patients required target vessel revascularisation, of which 11 (29.7%) belonged to the percutaneous transluminal coronary angioplasty group and 3 (10.0%) to the debulking group, the difference being statistically significant (p = 0.045). The freedom from target vessel revascularisation was 93.1 and 89.4 percent at 6 and 12 months in the debulking group, compared to 78.4 and 68.9 percent at the same time in the percutaneous transluminal coronary angioplasty group. This study thus demonstrates that percutaneous intervention for true bifurcation stenosis with stent implantation in the parent vessel and non-stent dilatation in the side branch provides favourable immediate and follow-up results. Debulking in comparison to plain balloon angioplasty of the side branch results in further improvement in clinical outcome and need for target vessel revascularisation on follow-up.
Authors:
D S Gambhir; S Singh; S C Sinha; G M Nair; R Arora
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian heart journal     Volume:  52     ISSN:  0019-4832     ISO Abbreviation:  Indian Heart J     Publication Date:    2000 May-Jun
Date Detail:
Created Date:  2000-09-21     Completed Date:  2000-09-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0374675     Medline TA:  Indian Heart J     Country:  INDIA    
Other Details:
Languages:  eng     Pagination:  289-96     Citation Subset:  IM    
Affiliation:
Department of Cardiology, GB Pant Hospital, New Delhi.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angioplasty, Transluminal, Percutaneous Coronary*
Atherectomy, Coronary*
Coronary Disease / mortality,  therapy*
Female
Humans
Male
Middle Aged
Retrospective Studies
Stents*
Survival Analysis
Treatment Outcome

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


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