Clinical outcomes of compromised side branch (stent jail) after coronary stenting with the NIR stent

Acute side-branch (SB) compromise or occlusion stent jail after native coro nary stenting is a matter of concern. Attempts at maintaining SB patency ca n be a technical challenge. The purpose of this study was to determine the clinical impact of SB compromise or occlusion in patients undergoing stenti ng of parent vessel lesions. We evaluated in-hospital and long-term clinica l outcomes (death, Q-wave myocardial infarction, and repeat revascularizati on rates at 6 months) in 318 consecutive patients undergoing NIR stent impl antation across an SB. Based on independent angiographic analysis, 218 (68. 6%) patients had no poststent SB compromise, 85 (26.7%) patients had narrow ed SB (> 70% narrowing, without total occlusion), and 15 (4.7%) patients ha d an occluded SB after stent implantation. The baseline patient and lesion characteristics were similar between the groups. Procedural success was 100 %. Patients with SB occlusion had a higher stents/lesion ratio (P < 0.006). Side-branch occlusion was associated with higher in-hospital ischemic comp lications (Q-wave myocardial infarction, 7%; non-Q-wave myocardial infarcti on, 20%; P < 0.05) compared to patients with SB compromise or normal SB. At 6-month follow-up, there was a trend for more myocardial infarctions in th e group with SB occlusion during the index procedure (Q-wave myocardial inf arction, 7% vs. 1% in the narrowed and 0% in normal SB; P = 0.09). However, late target lesion revascularization and mortality were similar in the thr ee groups (P = 0.91). SB occlusion after parent vessel stenting is associat ed with more frequent in-hospital Q-wave and non-Q-wave myocardial infarcti ons. However, with the NIR stent, side-branch compromise or occlusion does not influence late (6 month) major adverse events, including death, myocard ial infarction, or need for repeat revascularization., (C) 2001 Wiley-Liss, Inc.