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Comparison of Outcomes Between 1-and2-Stent Techniques for MedinaClassification 0.0.1 CoronaryBifurcation Lesions

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Author(s)
Ki Hong ChoiFrancesco BrunoYun-Kyeong ChoLeonardo De LucaYoung Bin SongJeehoon KangAlessio MattesiniHyeon-Cheol GwonAlessandra TruffaHyo-Soo KimWojciech WańhaWoo Jung ChunSebastiano GiliSeung-Ho HurGerard HelftSeung Hwan HanBernardo CorteseCheol Hyun LeeJavier EscanedHyuck-Jun YoonAlaide ChieffoJoo-Yong HahnGuglielmo GalloneSeung-Hyuk ChoiGaetano De FerrariBon-Kwon KooGiorgio QuadriFabrizio D'AscenzoChang-Wook NamOvidio de Filippo
Keimyung Author(s)
Cho, Yun KyeongHur, Seung HoLee, Cheol HyunYoon, Hyuck JunNam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
JACC Cardiovasc Interv
Issued Date
2023
Volume
16
Issue
17
Keyword
0.0.1Medina classificationbifurcationoutcomespercutaneous coronary interventionstent technique
Abstract
Background:
Although Medina 0.0.1 bifurcation lesions are often treated by percutaneous coronary intervention (PCI) in real-world practice, the optimal revascularization strategy for this lesion is uncertain.

Objectives:
The current study aimed to compare the clinical outcomes between 1- and 2-stent strategies in patients treated with PCI for Medina 0.0.1 bifurcation lesions.

Methods:
The extended BIFURCAT (Combined Insights From the Unified RAIN [Very Thin Stents for Patients with Left Main or Bifurcation in Real Life] and COBIS [Coronary Bifurcation Stenting] Bifurcation Registries) registry was obtained by patient-level merging the dedicated bifurcation COBIS II, III, and RAIN registries. Among 8,434 patients with bifurcation lesions undergoing PCI, 345 (4.1%) with Medina 0.0.1 lesions were selected for the current analysis. The primary endpoint was major adverse cardiac event (MACE, a composite of all-cause death, myocardial infarction, target vessel revascularization, and stent thrombosis) at 800 days.

Results:
In the total population, 209 patients (60.6%) received PCI with a 1-stent strategy and the remaining 136 patients (39.4%) with a 2-stent strategy. There was a tendency for higher use of a 1-stent strategy over time (36.0%, 47.4%, and 90.4% in 2003-2009, 2010-2014, and 2015-2017, respectively; P for trend < 0.001). For the treatment of Medina 0.0.1 lesions, there was no significant difference in the risk of MACE between 1- and 2-stent strategies (1 stent vs 2 stent, 14.3% vs 13.9%; HR: 1.034; 95% CI: 0.541-1.977; P = 0.92). The risk of MACE was also not significantly different when stratifying into 3 groups (1-stent crossover only, 1-stent with strut opening, and 2-stent strategy).

Conclusions:
In patients with a Medina 0.0.1 type bifurcation lesion, PCI with a 1-stent strategy showed comparable outcomes to that of a 2-stent strategy. (Coronary Bifurcation Stenting II [COBIS II]; NCT01642992; Coronary Bifurcation Stenting III [COBIS III]; NCT03068494; Very Thin Stents for Patients with Left Main or Bifurcation in Real Life [RAIN]; NCT03544294).
Keimyung Author(s)(Kor)
조윤경
허승호
이철현
윤혁준
남창욱
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1876-7605
Source
https://www.sciencedirect.com/science/article/pii/S1936879823009834
DOI
10.1016/j.jcin.2023.06.013
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45262
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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