The approach to coronary bifurcation treatment and its outcomes in Poland: The single center experience.

BACKGROUND: Coronary bifurcation lesions pose therapeutic problems during percutaneous coronary interventions. The aim of this study was to analyze the strategy of coronary bifurcation treatment and associated angiographic as well as clinical outcomes in a large hospital in Northern Poland.

METHODS: Between January 2012 and January 2014 patients with stable coronary artery disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) were treated with regular drug-eluting stents (rDES) or dedicated bifurcation stents (BiOSS Expert® or BiOSS LIM®). Clinical and angiographic controls were planned at 12 months. The primary endpoint was major adverse cardiovascular events (MACE) rate composed of cardiac death, myocardial infarction, and target lesion revascularization (TLR) at 12 months.

RESULTS: In total, 152 patients were enrolled in whom 158 stents were deployed (99 BiOSS stents and 59 rDES). Left anterior descending artery (50%) was the dominant target vessel followed by left circum¬flex (25%). There was no stent implantation failure. In 10 (6.3%) patients rDES was required within the side branch. At 12 months MACE rate was 11.2%, whereas TLR rate was 7.9%. In the logistic regression analysis final kissing balloon technique was the prognostic factor for better clinical outcome, whereas NSTE-ACS and true bifurcations were risk factors of a poor outcome.

CONCLUSIONS: Percutaneous coronary bifurcation treatment is a safe and effective procedure, and pro¬visional T-stenting is the preferred technique. Both rDES as well as dedicated bifurcation stents enabled a simple and fast bifurcation treatment option with comparable MACE and TLR rates. (Cardiol J 2017; 24, 6: 589-596).