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Open Access Highly Accessed Research article

Treatment of coronary bifurcation lesions: stent-covering of the side branch with and without PCI of the side branch: a retrospective analysis of all consecutive patients

Hubertus von Korn1*, Victor Stefan1, Reyn van Ewijk2, Kamalesh Chakraborty1, Burkhard Sanwald1, R Andel1, Jan Hemker1, Ulrich Hink3, Marc Ohlow4, Bernward Lauer4 and Thomas Muenzel3

Author Affiliations

1 Hetzelstift, Department of Cardiology, Stiftstr. 10, 67434 Neustadt, Germany

2 IMBEI, University Medical Center Mainz, Obere Zahlbacher Str. 69, 55131 Mainz, Germany

3 Department of Cardiology, University Hospital Mainz, Langenbeckstr. 1, 55131 Mainz, Germany

4 Zentralklinik Bad Berka, Department of Cardiology, Robert-Koch-Allee 9, 99437 Bad Berka, Germany

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BMC Cardiovascular Disorders 2013, 13:27  doi:10.1186/1471-2261-13-27

Published: 4 April 2013

Abstract

Background

Treatment of coronary bifurcation lesions is a complex problem.

Methods

This retrospective single-center study included all consecutive patients with PCI of coronary bifurcations with stent covering of the side branch (SB) between January 2008 - August 2011.

Two methods were compared: group A represented patients without treatment of SB, group B were patients with treatment of SB.

Results

Our study group (n = 98) was group A (n = 64, 65.3%) and group B (n = 34, 34.7%). Mean follow-up was 14.1 (group A) vs 12.3 (group B, p = ns) months.

Mean age (years) was 70.3 (group A) vs. 67.0 (group B, p = ns), NSTEMI/STEMI was present in 54.7% (group A) vs. 41,2% (group B, p = ns).

Duration of x-raying (min, group A vs group B) and the amount of contrast medium (ml) were significantly lower in group A: 18.1 min vs 20.1 min and 225.8 ml vs 307.4 ml (p < 0.05).

Final TIMI flow III inside the MB was reached in 98.4% (group A) vs. 97.1% (group B, p = ns), inside the SB in 84.4% vs. 94.1% (p = ns).

Target lesion revascularization and target vessel revascularization was seen in 15.9% (group A) vs 32.4% (group B, p = 0.07), cardiac death in 7.9% (group A) vs 14.7% (group B, p = 0.3).

All MACE revealed were: 23.8% (group A) vs. 47.1% (group B, p = 0.02).

Conclusion

In patients with coronary bifurcations a simpler strategy has a significantly lower MACE.

Trial registration

ClinicalTrials.gov Identifier: NCT01538186

Keywords:
Coronary bifurcation lesions; PCI side branch; Simple vs complex strategy