Effect of Wire Jailing at Side Branch in 1-Stent Strategy for Coronary Bifurcation Lesions

Yeon Jik Choi, Seung Jun Lee, Byeong Keuk Kim, Sung Jin Hong, Chul Min Ahn, Jung Sun Kim, Hyeon Cheol Gwon, Hyo Soo Kim, Woo Jung Chun, Seung Ho Hur, Chang Wook Nam, Seung Hwan Han, Seung Woon Rha, In Ho Chae, Jin Ok Jeong, Jung Ho Heo, Junghan Yoon, Do Sun Lim, Jong Seon Park, Kwang Soo ChaDoo Il Kim, Sang Yeub Lee, Kiyuk Chang, Byung Hee Hwang, So Yeon Choi, Myung Ho Jeong, Ki Hong Choi, Young Bin Song, Soon Jun Hong, Joon Hyung Doh, Bon Kwon Koo, Myeong Ki Hong, Yangsoo Jang

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Objectives: This study aimed to determine whether side branch (SB) wire jailing before main vessel (MV) stenting could prevent SB occlusion after the 1-stent strategy for bifurcation percutaneous coronary intervention. Background: The benefits of SB wire jailing in the 1-stent strategy remain unclear. Methods: From the COBIS (Coronary Bifurcation Stenting) III registry, 1,890 patients with bifurcation lesions who underwent the 1-stent strategy using second-generation drug-eluting stents were identified and classified into 2 groups according to the use of SB wire jailing: wire jailing (n = 819) and non–wire jailing (n = 1,071). The incidence of SB occlusion (Thrombolysis In Myocardial Infarction flow grade <3) and target lesion failure (cardiac death, myocardial infarction, or target lesion revascularization) was compared. Results: The incidence of final SB occlusion was not significantly different between wire jailing (1.8%) vs non–wire jailing (2.9%; P = 0.182). However, wire jailing at the SB was a significant protective factor for SB occlusion after MV stenting on multivariate analysis and was significantly associated with a lower incidence of SB occlusion in patients with significant stenoses (≥60%) at the SB (5.1% vs 11.3%; odds ratio: 0.42; 95% CI: 0.19-0.89; P = 0.028) or MV (3.1% vs 6.2%; odds ratio: 0.49; 95% CI: 0.24-0.95; P = 0.039). During follow-up (median 52 months), the incidence of target lesion failure was not significantly different between wire jailing and non–wire jailing (7.6% vs 6.3%; P = 0.343). Conclusions: During bifurcation percutaneous coronary intervention with the 1-stent strategy, wire jailing at the SB was associated with a lower rate of final SB occlusion following MV stenting in patients with severe stenoses at the SB or MV but not with overall bifurcation lesions. Long-term clinical outcomes were comparable between the 2 groups.

Original languageEnglish
Pages (from-to)443-455
Number of pages13
JournalJACC: Cardiovascular Interventions
Volume15
Issue number4
DOIs
Publication statusPublished - 2022 Feb 28

Keywords

  • drug-eluting stent(s)
  • myocardial infarction
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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