Two-stent techniques for coronary bifurcation lesions (main vessel first versus side branch first): Results from the COBIS (COronary BIfurcation Stenting) II registry

Taek Kyu Park, Young Bin Song, Jeong Hoon Yang, Joo Myung Lee, Joo Yong Hahn, Seung Hyuk Choi, Jin Ho Choi, Sang Hoon Lee, Ju Hyeon Oh, Cheol Woong Yu, Jin Ok Jeong, Hyeon Cheol Gwon

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aims: It has not been known which two-stent technique is best for treating bifurcation lesions. We aimed to compare the outcomes from main vessel (MV) first and side branch (SB) first techniques for patients with bifurcation lesions requiring a two-stent approach. Methods and results: A total of 673 patients with bifurcation lesions were treated with two-stent techniques: MV first (n=250) or SB first (n=423). The rate of a composite of cardiac death, myocardial infarction, or target lesion revascularisation (TLR) was similar in the two groups (SB first versus MV first, 15.1% versus 15.6% in the total population [p=0.90]; 14.3% versus 17.4% in a propensity score-matched population [p=0.80]). There were significant interactions associated with TLR risk between MV and SB first techniques according to angiographic factors. Patients in the MV first group had a lower risk of TLR when they had a lesion with MV diameter stenosis ≥70% (p for interaction=0.04), more severe stenosis of the MV than of the SB (p for interaction=0.008), or MV lesion length ≥18 mm (p for interaction=0.01). Conclusions: Clinical outcomes were similar for patients treated with MV or SB first two-stent techniques. Using "more severe lesion first" two-stent techniques might offer a favourable prognosis.

Original languageEnglish
Pages (from-to)835-842
Number of pages8
JournalEuroIntervention
Volume13
Issue number7
DOIs
Publication statusPublished - 2017 Sep 1

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Stents
Registries
Pathologic Constriction
Propensity Score
Population
Myocardial Infarction

Keywords

  • Bifurcation
  • Drug-eluting stent
  • Other technique

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Two-stent techniques for coronary bifurcation lesions (main vessel first versus side branch first) : Results from the COBIS (COronary BIfurcation Stenting) II registry. / Park, Taek Kyu; Song, Young Bin; Yang, Jeong Hoon; Lee, Joo Myung; Hahn, Joo Yong; Choi, Seung Hyuk; Choi, Jin Ho; Lee, Sang Hoon; Oh, Ju Hyeon; Yu, Cheol Woong; Jeong, Jin Ok; Gwon, Hyeon Cheol.

In: EuroIntervention, Vol. 13, No. 7, 01.09.2017, p. 835-842.

Research output: Contribution to journalArticle

Park, Taek Kyu ; Song, Young Bin ; Yang, Jeong Hoon ; Lee, Joo Myung ; Hahn, Joo Yong ; Choi, Seung Hyuk ; Choi, Jin Ho ; Lee, Sang Hoon ; Oh, Ju Hyeon ; Yu, Cheol Woong ; Jeong, Jin Ok ; Gwon, Hyeon Cheol. / Two-stent techniques for coronary bifurcation lesions (main vessel first versus side branch first) : Results from the COBIS (COronary BIfurcation Stenting) II registry. In: EuroIntervention. 2017 ; Vol. 13, No. 7. pp. 835-842.
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abstract = "Aims: It has not been known which two-stent technique is best for treating bifurcation lesions. We aimed to compare the outcomes from main vessel (MV) first and side branch (SB) first techniques for patients with bifurcation lesions requiring a two-stent approach. Methods and results: A total of 673 patients with bifurcation lesions were treated with two-stent techniques: MV first (n=250) or SB first (n=423). The rate of a composite of cardiac death, myocardial infarction, or target lesion revascularisation (TLR) was similar in the two groups (SB first versus MV first, 15.1{\%} versus 15.6{\%} in the total population [p=0.90]; 14.3{\%} versus 17.4{\%} in a propensity score-matched population [p=0.80]). There were significant interactions associated with TLR risk between MV and SB first techniques according to angiographic factors. Patients in the MV first group had a lower risk of TLR when they had a lesion with MV diameter stenosis ≥70{\%} (p for interaction=0.04), more severe stenosis of the MV than of the SB (p for interaction=0.008), or MV lesion length ≥18 mm (p for interaction=0.01). Conclusions: Clinical outcomes were similar for patients treated with MV or SB first two-stent techniques. Using {"}more severe lesion first{"} two-stent techniques might offer a favourable prognosis.",
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T1 - Two-stent techniques for coronary bifurcation lesions (main vessel first versus side branch first)

T2 - Results from the COBIS (COronary BIfurcation Stenting) II registry

AU - Park, Taek Kyu

AU - Song, Young Bin

AU - Yang, Jeong Hoon

AU - Lee, Joo Myung

AU - Hahn, Joo Yong

AU - Choi, Seung Hyuk

AU - Choi, Jin Ho

AU - Lee, Sang Hoon

AU - Oh, Ju Hyeon

AU - Yu, Cheol Woong

AU - Jeong, Jin Ok

AU - Gwon, Hyeon Cheol

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Aims: It has not been known which two-stent technique is best for treating bifurcation lesions. We aimed to compare the outcomes from main vessel (MV) first and side branch (SB) first techniques for patients with bifurcation lesions requiring a two-stent approach. Methods and results: A total of 673 patients with bifurcation lesions were treated with two-stent techniques: MV first (n=250) or SB first (n=423). The rate of a composite of cardiac death, myocardial infarction, or target lesion revascularisation (TLR) was similar in the two groups (SB first versus MV first, 15.1% versus 15.6% in the total population [p=0.90]; 14.3% versus 17.4% in a propensity score-matched population [p=0.80]). There were significant interactions associated with TLR risk between MV and SB first techniques according to angiographic factors. Patients in the MV first group had a lower risk of TLR when they had a lesion with MV diameter stenosis ≥70% (p for interaction=0.04), more severe stenosis of the MV than of the SB (p for interaction=0.008), or MV lesion length ≥18 mm (p for interaction=0.01). Conclusions: Clinical outcomes were similar for patients treated with MV or SB first two-stent techniques. Using "more severe lesion first" two-stent techniques might offer a favourable prognosis.

AB - Aims: It has not been known which two-stent technique is best for treating bifurcation lesions. We aimed to compare the outcomes from main vessel (MV) first and side branch (SB) first techniques for patients with bifurcation lesions requiring a two-stent approach. Methods and results: A total of 673 patients with bifurcation lesions were treated with two-stent techniques: MV first (n=250) or SB first (n=423). The rate of a composite of cardiac death, myocardial infarction, or target lesion revascularisation (TLR) was similar in the two groups (SB first versus MV first, 15.1% versus 15.6% in the total population [p=0.90]; 14.3% versus 17.4% in a propensity score-matched population [p=0.80]). There were significant interactions associated with TLR risk between MV and SB first techniques according to angiographic factors. Patients in the MV first group had a lower risk of TLR when they had a lesion with MV diameter stenosis ≥70% (p for interaction=0.04), more severe stenosis of the MV than of the SB (p for interaction=0.008), or MV lesion length ≥18 mm (p for interaction=0.01). Conclusions: Clinical outcomes were similar for patients treated with MV or SB first two-stent techniques. Using "more severe lesion first" two-stent techniques might offer a favourable prognosis.

KW - Bifurcation

KW - Drug-eluting stent

KW - Other technique

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