Immediate and long-term outcome of intracoronary stent implantation for true bifurcation lesions

OBJECTIVES The aim of this study was to evaluate the immediate and long-ter m outcome of intracoronary stent implantation for the treatment of coronary artery bifurcation lesions. BACKGROUND Balloon angioplasty of true coronary bifurcation lesions is asso ciated with a lower success and higher complication rate than most other le sion types. METHODS We treated 131 patients with bifurcation lesions with greater than or equal to 1 stent. Patients were divided into two groups; Group (Gp) 1 in cluded 77 patients treated with a stent in one branch and percutaneous tran sluminal coronary angioplasty (PTCA) (with or without atherectomy) in the s ide branch, and Gp 2 included 54 patients who underwent stent deployment in both branches. The Gp 2 patients were subsequently divided into two subgro ups depending on the technique of stent deployment. The Gp 2a included 19 p atients who underwent Y-stenting, and Gp 2b included 33 patients who underw ent T-stenting. RESULTS There were no significant differences between the groups in terms o f age, gender, frequency of prior myocardial infarction (MI) or coronary ar tery bypass grafting (CABG), or vessels treated. Procedural success rates w ere excellent (89.5 to 97.4%). After one-year follow-up, no significant dif ferences were seen in the frequency of major adverse events (death, MI, or repeat revascularization) between Gp 1 and Gp 2. Adverse cardiac events wer e higher with Y-stenting compared with T-stenting (86.3% vs. 30.4%, p = 0.0 04). CONCLUSIONS Stenting of bifurcation lesions can be achieved with a high suc cess rate. However, stenting of both branches offers no advantage over sten ting one branch and performing balloon angioplasty of the other branch. (C) 2000 by the American College of Cardiology.