TITLE:
Two-Stent Strategy for Bifurcation Lesions in Percutaneous Transluminal Coronary Angioplasty: Real-World Evidence
AUTHORS:
Dilip Kumar, Amit Malviya, Animesh Mishra, Rabin Chakraborty, Sanjeev S. Mukherjee, Soumya Patra, Arindam Pande, Rana Rathor Roy, Debopriyo Mondal, Ashesh Halder, Sumit Shanker
KEYWORDS:
Bifurcation Stenting, Coronary Bifurcation Lesions, Percutaneous
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.14 No.3,
March
29,
2024
ABSTRACT: Background: Bifurcation lesions pose a high risk for adverse events after
percutaneous coronary intervention (PCI). Evidence supporting the benefits of
the two-stent strategy (2SS) for treating coronary bifurcation lesions in India
is limited. This study aimed to evaluate the clinical outcomes of various 2SSs
for percutaneous transluminal coronary angioplasty for bifurcation lesions in
India. Materials and Methods: This retrospective, observational,
multicentric, real-world study included 64 patients over 8 years. Data on
demographics, medical history, PCI procedures, and outcomes were recorded.
Descriptive statistics were computed using the SPSS software. Results: Patients (n = 64) had an average age of 65.3 ± 11.1
years, with 78.1% males. Acute coronary syndrome was reported in 18.8%, chronic
stable angina in 40.6%, and unstable angina in 34.4% of participants.
Two-vessel disease was observed in 98.4% of patients, and 99.4% had true
bifurcation lesions. The commonly involved vessels were the left anterior
descending artery (50%), left circumflex coronary artery (34.4%), and first
diagonal artery (43.8%). Mean percent diameter stenosis was 87.2% ± 10.1%.
The mean number of stents used was 2.00 ± 0.34.
The 2SS techniques included the T and small protrusion (TAP) (39.1%), double
kissing (DK) crush (18.8%), and the culotte techniques (14.1%). Procedural and
angiographic success rate was 92.18%. Major adverse cardiovascular events at
1-year follow-up occurred in 7.8% of cases. Conclusion: The 2SS for
bifurcation lesions showed favorable in-hospital and follow-up outcomes.
Findings can serve as a resource for bifurcation angioplasty in India. Larger
real-world studies with robust methodology are needed to validate these
results.