Abstract 4499: A Randomized Pilot Trial for Treatment of Large Bifurcation Lesions with Simultaneous Kissing Stents: PRECISE-SKS Trial
Optimal stenting strategy for coronary bifurcation lesions continues to evolve with most of the earlier studies favoring stenting the main vessel (MV) over stenting both MV and the side-branch (SB). Simultaneous kissing stents (SKS) techniques involves deploying two stents simultaneously in both branches with guaranteed coverage of SB ostium, no stent deformation and excellent long-term results. Present SKS-Precise study is a randomized trial comparing SKS technique vs conventional stent strategy (CSS) of deploying stent in MV and provisional stent of the SB for the treatment of large bifurcation lesions (Duke type D). The primary endpoints were angiographic restenosis (>50% diameter stenosis of the target lesion) at 8-month and a major adverse cardiac events (MACE: TLR, stent thrombosis, MI or death) at 1-yr. A total of 100 pts were randomized (51 in SKS group and 49 in CSS group), with 1-yr clinical follow-up available in all pts and angiographic follow-up in 83 cases. The SB stenting in CSS group was needed in 28%. All pts received sirolimus-eluting stents (SES). Baseline clinical and angiographic variables were comparable, with lower angiographic success of SB in CSS. The SKS technique for large bifurcation lesions resulted in a trend towards better acute success and long-term patency, especially in the SB, compared to conventional stent technique. Therefore, SKS technique can be safely recommended in the treatment of the true large coronary bifurcations.