Immediate, Short-Term, Intermediate, and Long-Term Clinical Outcomes of True Bifurcation Stenting

TL;DR

This study examines the clinical outcomes of different stenting techniques for coronary artery bifurcation lesions over various timeframes.

Contribution

The study provides a comprehensive analysis of long-term outcomes and complications of true bifurcation stenting techniques.

Findings

The two-stent strategy showed good long-term outcomes with low complication rates.

Final kissing balloon inflation and bifurcation involvement were significantly associated with major adverse cardiac events.

MACEs were linked to mortality, with previous PCI and hypertension increasing mortality risk.

Abstract

Introduction: Coronary artery bifurcation lesion is an epicardial stenosis that, when compared to non-bifurcation lesions, poses a greater risk of adverse events and can compromise prognosis. This study aims to investigate the clinical efficacy of different stenting techniques, particularly in terms of their immediate, short-term, intermediate, and long-term outcomes in patients with true bifurcation lesions.

Methodology: This retrospective observational cohort study was conducted in a tertiary cardiac hospital in Islamabad, from February 1, 2015, to February 28, 2021. A total of 172 patients who met the inclusion criteria and underwent percutaneous coronary intervention were selected using a consecutive sampling technique. Follow-up was maintained for three years to assess procedural outcomes.

Results: Of the 172 participants, the majority were males (69%) and only 4% were above 75 years of age. A significant relation between major adverse cardiac events (MACEs) with acute coronary syndrome (ACS) and previous percutaneous coronary intervention (PCI) (p < 0.000) was observed. Procedural success was good in all patients using the drug-eluting stent. The MAC rate was 6.9% and the final kissing balloon inflation, stenting technique, and bifurcation involvement were significantly associated with MACE occurrence (p < 0.01), and mortality was reported in two patients (1.16%). MACEs were associated with mortality; previous PCI and hypertension increased the risk of mortality.

Conclusion: The two-stent strategy can be used with good long-term outcomes and low complication rates.

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