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Comparison of 2-Stenting Strategies Depending on Sequence or Technique for Bifurcation Lesions in the Second-Generation Drug-Eluting Stent Era - Analysis From the COBIS (Coronary Bifurcation Stenting) III Registry

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Author(s)
Jeehoon KangJung-Kyu HanHan-Mo YangKyung Woo ParkHyun-Jae KangHyeon-Cheol GwonWoo Jung ChunSeung-Ho HurSeung Hwan HanSeung-Woon RhaIn-Ho ChaeJin-Ok JeongJung Ho HeoJunghan YoonDo-Sun LimJong-Seon ParkMyeong-Ki HongJoon-Hyung DohKwang Soo ChaDoo-Il KimSang Yeub LeeKiyuk ChangByung-Hee HwangSo-Yeon ChoiMyung Ho JeongYoung Bin SongKi Hong ChoiSoon-Jun HongChang-Wook NamBon-Kwon KooHyo-Soo Kim
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Circ J
Issued Date
2021
Volume
85
Issue
11
Keyword
2-stenting techniqueAdjunctive pharmacotherapyBifurcationDrug-eluting stentsLeft main disease
Abstract
Background:
It has not been determined which specific 2-stenting strategy is the best for bifurcation lesions. Our aim was to investigate the clinical outcomes of various 2-stenting strategies in the era of 2nd-generation drug-eluting stents (2G-DES).

Methods and Results:
We analyzed 454 patients who finally underwent 2-stenting for a bifurcation lesion, from among 2,648 patients enrolled in the COBIS III registry. The primary outcome was target lesion failure (TLF). Patients were analyzed according to stenting sequence (provisional [main vessel stenting first] vs. systemic [side branch stenting first]) and stenting technique (crush vs. T vs. culotte vs. kissing/V stenting). Overall, 4.4 years' TLF after 2-stenting treatment for bifurcation lesion was excellent: TLF 11.2% and stent thrombosis 1.3%. There was no difference in TLF according to 2-stenting strategy (11.1% vs. 10.5%, P=0.990 for provisional and systemic sequence; 8.6% vs. 14.4% vs. 12.9% vs. 12.2%, P=0.326 for crush, T, culotte, kissing/V technique, respectively). Only left main (LM) disease and a shorter duration of dual antiplatelet therapy (DAPT) were associated with TLF. The distribution of DAPT duration differed between patients with and without TLF, and the time-point of intersection was 2.5 years. Also, the side branch was the most common site of restenosis.

Conclusions:
The stenting sequence or technique did not affect clinical outcomes, but LM disease and shorter DAPT were associated with TLF, in patients with bifurcation lesions undergoing 2-stenting with 2G-DES.
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine (의과대학)
Citation
Jeehoon Kang et al. (2021). Comparison of 2-Stenting Strategies Depending on Sequence or Technique for Bifurcation Lesions in the Second-Generation Drug-Eluting Stent Era - Analysis From the COBIS (Coronary Bifurcation Stenting) III Registry. Circ J, 85(11), 1944–1955. doi: 10.1253/circj.CJ-20-0999
Type
Article
ISSN
1347-4820
Source
https://www.jstage.jst.go.jp/article/circj/85/11/85_CJ-20-0999/_article
DOI
10.1253/circj.CJ-20-0999
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43786
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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