Which Stenting Technique Is Best for Bifurcation Lesions?

In a randomized trial, a provisional side-branch stenting strategy and a specified crush technique had similar 6-month outcomes.

To compare two different approaches to the technical challenges of percutaneous coronary intervention for bifurcation stenoses, investigators in this Italian and German multicenter study randomized 350 patients to receive sirolimus-eluting stents either by crush stenting of both vessels or by a provisional side-branch stenting strategy. All patients had >50% stenosis in both the main branch and the ostium of the side branch.

The angiographic success rate was similar in the crush (99%) and provisional (98%) groups. A stent was placed in the side branch in 31% of patients in the provisional group because of residual stenosis >50% (72%), type B or worse dissection (39%), or TIMI flow of <3 (2%). The rate of adverse cardiac events at 6 months wa…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI