DK mini-culotte stenting in the treatment of true coronary bifurcation lesions: a propensity score matching comparison with T-provisional stenting

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• 作者：Lin Fan ; Lianglong Chen ; Yukun Luo ; Linlin Zhang ; Wenliang Zhong…
• 关键词：Coronary bifurcation lesions ; Percutaneous coronary intervention ; DK mini ; culotte ; T ; provisional stenting
• 刊名：Heart and Vessels
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：31
• 期：3
• 页码：308-321
• 全文大小：1,060 KB
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• 作者单位：Lin Fan (1) (2)
  Lianglong Chen (1) (2) (3)
  Yukun Luo (1) (2)
  Linlin Zhang (1) (2)
  Wenliang Zhong (1) (2)
  Chaogui Lin (1) (2)
  Zhaoyang Chen (1) (2)
  Yafei Peng (1) (2)
  Xingchun Zhen (1) (2)
  Xianfeng Dong (1) (2)
  
  1. Department of Cardiology, Union Hospital, Fujian Medical University, Fujian, China
  2. Institute of Coronary Heart Disease, Fujian, China
  3. Xinquan Road 29, Fuzhou, 350001, China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Cardiac Surgery
  Vascular Surgery
  Biomedical Engineering
  Interventional Radiology
  Ultrasound
  
• 出版者：Springer Japan
• ISSN：1615-2573

文摘

The conventional culotte technique remains not to be widely used for the treatment of coronary bifurcation lesions due to its inherent drawbacks. Here, we developed a double kissing mini-culotte stenting (DK mini-culotte) and assessed its efficacy and safety by a propensity score matching comparison (PSM) with T-provisional stenting. From June 2010 to June 2012, a total of 223 consecutive patients with true coronary bifurcation lesions (TCBLs) were treated with DK mini-culotte (91 patients with 92 lesions) or T-provisional stenting (132 patients with 135 lesions). We performed a PSM to correct the confounders from clinical and lesion’s characteristics. The primary endpoint was cumulative major adverse cardiac event (MACE) at 1 year including cardiac death, myocardial infarction, and target vessel revascularization or target lesion revascularization (TVR/TLR). The secondary endpoint was the rate of side branch (SB) restenosis at 12 months. After a PSM, there were 66 patients in each group. Additional SB stenting in the T-provisional group was performed in 10 (15.2 %) lesions. The incidence of 1-year cumulative MACE was 4.55 % for the DK mini-culotte versus 13.6 % for T-provisional stenting (P = 0.127), the rate of TVR/TLR was 1.52 % for DK mini-culotte versus 12.12 % for T-provisional stenting (P = 0.033). The SB binary restenosis rate was 5.6 % in the DK mini-culotte group and 22.4 % in the T-provisional group (P = 0.014). In summary, despite that there is no difference in MACE between groups, DK mini-culotte significantly reduce TVR/TLR and SB restenosis in the treatment of true coronary bifurcation lesions.