Randomized study on simple versus complex stenting of coronary artery bifurcation lesions: the Nordic bifurcation study
2006 (English)In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 114, no 18, 1955-1961 p.Article in journal (Refereed) Published
Background - The optimal stenting strategy in coronary artery bifurcation lesions is unknown. In the present study, a strategy of stenting both the main vessel and the side branch ( MV + SB) was compared with a strategy of stenting the main vessel only, with optional stenting of the side branch ( MV), with sirolimus-eluting stents.
Methods and Results - A total of 413 patients with a bifurcation lesion were randomized. The primary end point was a major adverse cardiac event: cardiac death, myocardial infarction, target-vessel revascularization, or stent thrombosis after 6 months. At 6 months, there were no significant differences in rates of major adverse cardiac events between the groups ( MV + SB 3.4%, MV 2.9%; P = NS). In the MV + SB group, there were significantly longer procedure and fluoroscopy times, higher contrast volumes, and higher rates of procedure-related increases in biomarkers of myocardial injury. A total of 307 patients had a quantitative coronary assessment at the index procedure and after 8 months. The combined angiographic end point of diameter stenosis > 50% of main vessel and occlusion of the side branch after 8 months was found in 5.3% in the MV group and 5.1% in the MV + SB group ( P = NS).
Conclusions - Independent of stenting strategy, excellent clinical and angiographic results were obtained with percutaneous treatment of de novo coronary artery bifurcation lesions with sirolimus-eluting stents. The simple stenting strategy used in the MV group was associated with reduced procedure and fluoroscopy times and lower rates of procedure-related biomarker elevation. Therefore, this strategy can be recommended as the routine bifurcation stenting technique.
Place, publisher, year, edition, pages
2006. Vol. 114, no 18, 1955-1961 p.
stents, angioplasty, angiography, restenosis, bifurcation, follow-up studies, stenosis
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-24891DOI: 10.1161/CIRCULATIONAHA.106.664920ISI: 000241666800012PubMedID: 17060387OAI: oai:DiVA.org:uu-24891DiVA: diva2:52665