Bifurcation lesions: Two stents versus one stent - Immediate and follow-upresults

OBJECTIVES The purpose of this study was to evaluate two different techniqu es of stent placement in bifurcation lesions. BACKGROUND Although stent placement with dedicated techniques has been sugg ested to be a useful therapeutic modality for bifurcation lesions, limited information is available if stent placement on the side branch and on the p arent branch provides any advantage over a simpler strategy of stenting the parent vessel and balloon angioplasty of the side branch. METHODS Between March 1993 and April 1999, we treated a total of 92 patient s with bifurcation lesions with two strategies: stenting both vessels (grou p B, n = 53) or stenting the parent vessel and balloon angioplasty of the s ide branch (group P, n = 39). Paired angiograms were analyzed by quantitati ve angiography, and clinical follow-up was obtained. RESULTS Stent placement on both branches resulted in a lower residual steno sis (7.4 +/- 10.9% vs. 23.4% +/- 18.7%, p < 0.001) in the side branch. Acut e procedural success was similar in the two groups (group B: 87% vs. Group P: 92%). In-hospital major adverse cardiac events (MACE) occurred only in g roup B (13% vs. 0%, p < 0.05). At the six-month follow-up, the angiographic restenosis rate (group B: 62% vs. Group P: 48%) and the target lesion reva scularization rate (38% vs. 36%, respectively) were similar in the two grou ps. There was no difference in the incidence of six-month total MACE (51% v s. 38%). CONCLUSIONS For the treatment of true bifurcation lesions, a complex strate gy of stenting both vessels provided no advantage in terms of procedural su ccess and late outcome versus a simpler strategy of stenting only the paren t vessel. (J Am Coll Cardiol 2000;35:1145-51) (C) 2000 by the American Coll ege of Cardiology.