Abstract 13798: Midterm Outcomes of Bifurcation Lesions After Culotte Stenting With Biolimus-eluting Stent Compared With Various Drug-eluting Stents
Purpose: Even though drug-eluting stent (DES) has reduced the rate of in-stent restenosis, the clinical outcomes of bifurcation lesions using two-stent technique are not always good enough and the details are little known such as the difference between each DES. This study aimed to investigate the midterm outcomes of bifurcation lesions after culotte stenting with various DES.
Methods: The study population consisted of 297 bifurcation lesions with culotte stenting (293 patients) which were treated exclusively with DES from November 2004 to April 2012: 109 biolimus-eluting stents (BES) exclusively, 47 everolimus-eluting stents (EES), 48 zotarolimus-eluting stents (ZES), 19 sirolimus-eluting stents (SES), 9 paclitaxel-eluting stents (PES), and 65 hybrid stents. Midterm follow-up angiography was scheduled at 8 months after procedure unless any clinical reasons were indicated earlier. In addition to restenosis at stent-implanted site, we particularly investigated that at bifurcation site. Restenosis at bifurcation site was defined as a percent diameter > 50% within 5 mm from the stent-implanted bifurcation lesion both in the main and side branches. The main branch was basically defined as that with the bigger vessel diameter.
Results: The restenosis rate at bifurcation site in the side branch was significantly lower in BES than in the total of other DES (EES, ZES, SES, and PES): main branch, 6.4% vs. 8.2% (p=0.802); side branch, 10.1% vs. 23.0% (p=0.013). The restenosis rate at left main coronary trunk (LMT) in the side branch was also significantly lower in BES than in the total of other DES: main branch, 5.4% vs. 7.0% (p=1.000); side branch, 5.4% vs. 25.6% (p=0.031). Quantitative coronary angiographic analysis data about LMT is shown in the table.
Conclusions: The restenosis rate in patients treated for bifurcation lesions with culotte stenting using BES, especially for unprotected left main coronary artery lesions, could be better than that of the total of DES.
- © 2013 by American Heart Association, Inc.