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Comparison of 2-stenting strategies depending on sequence or technique for bifurcation lesions in the second-generation drug-eluting stent era -analysis from the cobis (coronary bifurcation stenting) iii registry

Kang, J | Han, JK | Yang, HM | Park, KW | Kang, HJ | Gwon, HC | Chun, WJ | Hur, SH | Han, SH | Rha, SW | Chae, IH | Jeong, JO | Heo, JH | Yoon, J | Lim, DS | Park, JS | Hong, MK | Doh, JH | Cha, KS | Kim, DI | Lee, SY | Chang, K | Hwang, BH | Choi, SY  | Jeong, MH | Song, YB | Choi, KH | Hong, SJ | Nam, CW | Koo, BK | Kim, HS
Circulation journal, 85(11). : 1944-1955, 2021
Journal Title
Circulation journal
Background: It has not been determined which specific 2-stenting strategy is the best for bifurcation lesions. Our aim was to investigate the clinical outcomes of various 2-stenting strategies in the era of 2nd-generation drug-eluting stents (2G-DES). Methods and Results: We analyzed 454 patients who finally underwent 2-stenting for a bifurcation lesion, from among 2,648 patients enrolled in the COBIS III registry. The primary outcome was target lesion failure (TLF). Patients were analyzed according to stenting sequence (provisional [main vessel stenting first] vs. systemic [side branch stenting first]) and stenting technique (crush vs. T vs. culotte vs. kissing/V stenting). Overall, 4.4 years' TLF after 2-stenting treatment for bifurcation lesion was excellent: TLF 11.2% and stent thrombosis 1.3%. There was no difference in TLF according to 2-stenting strategy (11.1% vs. 10.5%, P=0.990 for provisional and systemic sequence; 8.6% vs. 14.4% vs. 12.9% vs. 12.2%, P=0.326 for crush, T, culotte, kissing/V technique, respectively). Only left main (LM) disease and a shorter duration of dual antiplatelet therapy (DAPT) were associated with TLF. The distribution of DAPT duration differed between patients with and without TLF, and the time-point of intersection was 2.5 years. Also, the side branch was the most common site of restenosis. Conclusions: The stenting sequence or technique did not affect clinical outcomes, but LM disease and shorter DAPT were associated with TLF, in patients with bifurcation lesions undergoing 2-stenting with 2G-DES.


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Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
Ajou Authors
최, 소연
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