Stent Insertion in Coronary Bifurcation Lesions: Procedural Success and Long-term Follow-up Results

We aimed to evaluate procedural success rates and long-term follow-up results of patients who underwent stent insertion for coronary bifurcation lesions which are associated with a lower success and higher complication rate than most other lesion types. Forty-five patients who underwent stent implantation for coronary bifurcation lesions were included in the study. Angiographic features and quantitative analysis of each lesion, procedural success rates and in-hospital and long-term clinical outcomes were assessed.
RESULTS
Forty-five patients were included, mean age 55.3±11.6 years, 75.5% male, 46.4% with unstable angina, 40% stable angina, and 13.4% acute myocardial infarction. The left anterior descending/diagonal bifurcation was involved in 46.9% of cases, circumflex/marginal in 28.9%, PDA/PLA in 19.7%, left anterior descending/circumflex in 4.5%. The main branch (3.06±0.36 mm reference diameter) and the side branch (2.4±0.39 mm) was stented in all cases. Procedural success was obtained in 84.4% in both branches. At 1-month follow-up, the major cardiac event rate (MACE) was 8.8% (death 4.4%, emergency CABG 0%, non-Q-wave MI 2.2%, repeat PTCA 2.2%). At 15±8.9 month follow-up, the total MACE rate was 44.5% (death 15.6%, CABG 15.6%, Q-wave MI 6.7%, repeat PTCA 13.3%).
CONCLUSION
We conclude that the treatment of bifurcation lesions with stenting is associated with decreased success and increased complication and MACE rates compared with nonbifurcation lesions.