Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―

Seung Hwa Lee, Young Bin Song, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Joo Yong Hahn, Jin Ho Choi, Seung Hyuk Choi, Sang Hoon Lee, Joong Hyun Ahn, Keumhee C. Carriere, Myung Ho Jeong, Hyo-Soo Kim, Ju Hyeon Oh, Yangsoo Jang, Hyeon Cheol Gwon

Research output: Contribution to journalArticle

Abstract

Background: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach. Methods and Results: A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization. SB predilation was performed in 437 (40.4%) patients. Abrupt (10.5% vs. 11.3%; P=0.76) or final SB occlusion (2.7% vs. 3.9%; P=0.41) showed no differences between the predilation and non-predilation groups. The rates of angiographic success (69.1% vs. 52.9%, P<0.001) and SB stent implantation (69.1% vs. 52.9%, P<0.001) were significantly higher in the predilation group. During a median follow-up of 36 months, we found no significant difference between the groups in the rate of MACE (9.4% vs. 11.5%; P=0.67) in a propensity score-matched population. In subgroup analysis, patients with minimal luminal diameter of the parent vessel ≤1 mm benefited from SB predilation in terms of preventing abrupt SB occlusion (P for interaction=0.04). Conclusions: For the treatment of true bifurcation lesions, SB predilation improved acute angiographic and procedural outcomes, but could not improve long-term clinical outcomes. It may benefit patients with severe stenosis in the parent vessel.

Original languageEnglish
Pages (from-to)1293-1301
Number of pages9
JournalCirculation Journal
Volume82
Issue number5
DOIs
StatePublished - 1 Jan 2018

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Registries
Propensity Score
Percutaneous Coronary Intervention
Stents
Pathologic Constriction
Myocardial Infarction
Population
Therapeutics

Keywords

  • Bifurcation
  • Percutaneous coronary intervention
  • Side branch predilation

Cite this

Lee, Seung Hwa ; Song, Young Bin ; Lee, Joo Myung ; Park, Taek Kyu ; Yang, Jeong Hoon ; Hahn, Joo Yong ; Choi, Jin Ho ; Choi, Seung Hyuk ; Lee, Sang Hoon ; Ahn, Joong Hyun ; Carriere, Keumhee C. ; Jeong, Myung Ho ; Kim, Hyo-Soo ; Oh, Ju Hyeon ; Jang, Yangsoo ; Gwon, Hyeon Cheol. / Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―. In: Circulation Journal. 2018 ; Vol. 82, No. 5. pp. 1293-1301.
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abstract = "Background: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach. Methods and Results: A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization. SB predilation was performed in 437 (40.4{\%}) patients. Abrupt (10.5{\%} vs. 11.3{\%}; P=0.76) or final SB occlusion (2.7{\%} vs. 3.9{\%}; P=0.41) showed no differences between the predilation and non-predilation groups. The rates of angiographic success (69.1{\%} vs. 52.9{\%}, P<0.001) and SB stent implantation (69.1{\%} vs. 52.9{\%}, P<0.001) were significantly higher in the predilation group. During a median follow-up of 36 months, we found no significant difference between the groups in the rate of MACE (9.4{\%} vs. 11.5{\%}; P=0.67) in a propensity score-matched population. In subgroup analysis, patients with minimal luminal diameter of the parent vessel ≤1 mm benefited from SB predilation in terms of preventing abrupt SB occlusion (P for interaction=0.04). Conclusions: For the treatment of true bifurcation lesions, SB predilation improved acute angiographic and procedural outcomes, but could not improve long-term clinical outcomes. It may benefit patients with severe stenosis in the parent vessel.",
keywords = "Bifurcation, Percutaneous coronary intervention, Side branch predilation",
author = "Lee, {Seung Hwa} and Song, {Young Bin} and Lee, {Joo Myung} and Park, {Taek Kyu} and Yang, {Jeong Hoon} and Hahn, {Joo Yong} and Choi, {Jin Ho} and Choi, {Seung Hyuk} and Lee, {Sang Hoon} and Ahn, {Joong Hyun} and Carriere, {Keumhee C.} and Jeong, {Myung Ho} and Hyo-Soo Kim and Oh, {Ju Hyeon} and Yangsoo Jang and Gwon, {Hyeon Cheol}",
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Lee, SH, Song, YB, Lee, JM, Park, TK, Yang, JH, Hahn, JY, Choi, JH, Choi, SH, Lee, SH, Ahn, JH, Carriere, KC, Jeong, MH, Kim, H-S, Oh, JH, Jang, Y & Gwon, HC 2018, 'Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―', Circulation Journal, vol. 82, no. 5, pp. 1293-1301. https://doi.org/10.1253/circj.CJ-17-0921

Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―. / Lee, Seung Hwa; Song, Young Bin; Lee, Joo Myung; Park, Taek Kyu; Yang, Jeong Hoon; Hahn, Joo Yong; Choi, Jin Ho; Choi, Seung Hyuk; Lee, Sang Hoon; Ahn, Joong Hyun; Carriere, Keumhee C.; Jeong, Myung Ho; Kim, Hyo-Soo; Oh, Ju Hyeon; Jang, Yangsoo; Gwon, Hyeon Cheol.

In: Circulation Journal, Vol. 82, No. 5, 01.01.2018, p. 1293-1301.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of side branch predilation in coronary bifurcation stenting with the provisional approach ― results from the COBIS (Coronary bifurcation stenting) II registry ―

AU - Lee, Seung Hwa

AU - Song, Young Bin

AU - Lee, Joo Myung

AU - Park, Taek Kyu

AU - Yang, Jeong Hoon

AU - Hahn, Joo Yong

AU - Choi, Jin Ho

AU - Choi, Seung Hyuk

AU - Lee, Sang Hoon

AU - Ahn, Joong Hyun

AU - Carriere, Keumhee C.

AU - Jeong, Myung Ho

AU - Kim, Hyo-Soo

AU - Oh, Ju Hyeon

AU - Jang, Yangsoo

AU - Gwon, Hyeon Cheol

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach. Methods and Results: A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization. SB predilation was performed in 437 (40.4%) patients. Abrupt (10.5% vs. 11.3%; P=0.76) or final SB occlusion (2.7% vs. 3.9%; P=0.41) showed no differences between the predilation and non-predilation groups. The rates of angiographic success (69.1% vs. 52.9%, P<0.001) and SB stent implantation (69.1% vs. 52.9%, P<0.001) were significantly higher in the predilation group. During a median follow-up of 36 months, we found no significant difference between the groups in the rate of MACE (9.4% vs. 11.5%; P=0.67) in a propensity score-matched population. In subgroup analysis, patients with minimal luminal diameter of the parent vessel ≤1 mm benefited from SB predilation in terms of preventing abrupt SB occlusion (P for interaction=0.04). Conclusions: For the treatment of true bifurcation lesions, SB predilation improved acute angiographic and procedural outcomes, but could not improve long-term clinical outcomes. It may benefit patients with severe stenosis in the parent vessel.

AB - Background: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach. Methods and Results: A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization. SB predilation was performed in 437 (40.4%) patients. Abrupt (10.5% vs. 11.3%; P=0.76) or final SB occlusion (2.7% vs. 3.9%; P=0.41) showed no differences between the predilation and non-predilation groups. The rates of angiographic success (69.1% vs. 52.9%, P<0.001) and SB stent implantation (69.1% vs. 52.9%, P<0.001) were significantly higher in the predilation group. During a median follow-up of 36 months, we found no significant difference between the groups in the rate of MACE (9.4% vs. 11.5%; P=0.67) in a propensity score-matched population. In subgroup analysis, patients with minimal luminal diameter of the parent vessel ≤1 mm benefited from SB predilation in terms of preventing abrupt SB occlusion (P for interaction=0.04). Conclusions: For the treatment of true bifurcation lesions, SB predilation improved acute angiographic and procedural outcomes, but could not improve long-term clinical outcomes. It may benefit patients with severe stenosis in the parent vessel.

KW - Bifurcation

KW - Percutaneous coronary intervention

KW - Side branch predilation

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U2 - 10.1253/circj.CJ-17-0921

DO - 10.1253/circj.CJ-17-0921

M3 - Article

C2 - 29576596

AN - SCOPUS:85045966608

VL - 82

SP - 1293

EP - 1301

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 5

ER -