Conflict of interest: The authors declare no conflicts of interest.
Coronary Artery Disease
Intravascular ultrasound-guided systematic two-stent techniques for coronary bifurcation lesions and reduced late stent thrombosis
Article first published online: 14 NOV 2012
Copyright © 2012 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 81, Issue 3, pages 456–463, February 2013
How to Cite
Chen, S.-L., Ye, F., Zhang, J.-J., Tian, N.-L., Liu, Z.-Z., Santoso, T., Zhou, Y.-J., Jiang, T.-M., Wen, S.-Y. and Kwan, T. W. (2013), Intravascular ultrasound-guided systematic two-stent techniques for coronary bifurcation lesions and reduced late stent thrombosis. Cathet. Cardiovasc. Intervent., 81: 456–463. doi: 10.1002/ccd.24601
- Issue published online: 18 FEB 2013
- Article first published online: 14 NOV 2012
- Accepted manuscript online: 17 AUG 2012 12:24AM EST
- Manuscript Accepted: 9 AUG 2012
- Manuscript Received: 18 FEB 2012
- coronary bifurcation lesions;
- two-stent technique;
- intravascular ultrasound;
- stent thrombosis
The effects of intravascular ultrasound (IVUS)-guided complex approaches using drug-eluting stents (DES) for coronary bifurcation lesions on clinical outcomes has not yet been studied in detail.
Our objective was to analyze the difference in 1-year outcomes following two-stent techniques involving implantation of DES for coronary bifurcation lesions between IVUS-guided and angiography-guided groups.
From May 26, 2007 to March 24, 2010, 628 patients received two-stent techniques (324 in the IVUS-guided group and 304 angiography-guided) and were prospectively studied. We compared major adverse cardiac events (MACE, including cardiac death, stent thrombosis [ST], myocardial infarction [MI] and target lesion/vessel revascularization) at 12-months follow-up, before and after adjusting for propensity score matching.
At 12-months after the indexed procedure, patients in the angiography-guided group had significantly increased in-stent restenosis. Compared to the angiography-guided group, the IVUS-guided group had a significantly lower overall unadjusted ST rate (1.2% vs. 6.9%, P < 0.001), definite ST (0.6% vs. 5.3%, P < 0.001), late ST (0.6% vs. 4.3%, P = 0.003), MI (4.6% vs. 8.9%, P = 0.038) and cardiac death (0.9% vs. 3.3%, P = 0.049). By propensity score matching, 123 paired patients were matched. The late ST at 12-months follow-up was 0% in the IVUS-guided group versus 4.9% in the angiography-guided group (P = 0.029), resulting in significant differences in ST-elevation MI between the two groups (2.4% vs. 9.8%, P = 0.030).
The IVUS-guided two-stent technique was associated with significantly reduced late stent thrombosis, with a resultant reduction in ST-elevation MI. © 2012 Wiley Periodicals, Inc.