Current Challenges in Coronary Bifurcation Interventions
Abstract
:1. Introduction
2. The Coronary Bifurcation Structure
3. Epidemiology
4. Side Branch Compromise
4.1. The Balloon Angioplasty Era
4.2. The Stent Era
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5. Restenosis in Bifurcation Lesions
6. Bifurcation Optimization Techniques
6.1. The Kissing Balloon Inflation (KBI) Technique
6.2. The Proximal Optimization Technique (POT)
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author | Randomization | Technique | Number of Patients | Follow-Up (Months) | Restenosis Rate, % | TLR (%) |
---|---|---|---|---|---|---|
Suwaidi | No | S + S | 77 | 12 | - | 19.4 |
S + B | 54 | - | 20.5 | |||
Chevalier | No | S + S | 50 | 6 | 28 | 24 |
Yamashita | No | S + S | 53 | 6 | 62 | 38 |
S + B | 39 | 48 | 36 | |||
Pan | No | S + S | 23 | 18 | 43 | 39 |
S + B | 47 | 19 | 17 | |||
Anzuini | No | S + S | 45 | 12 | 25 | 35.5 |
S + B | 45 | 12.5 | 15.5 | |||
Brunel | No | S + S | 50 | 6 | 57 | 43 |
S + B | 56 | 21 | 8 | |||
Brunel | No | PTS | 186 | 7 | MB—9.1 | 15.9 |
SB—25.3 | ||||||
Rux | No | S + B | 370 | 6 | 13 | 15.7 |
S + S | 45 | 16.2 | 33.3 | |||
Beijk | No | S + B | 465 | 12 | 11.3 | 8.6 |
R stent | ||||||
Lefevre | No | S + B | 724 | 7 | MB/SB - | 13.6 |
7.3/7.3 | ||||||
S + S | 425 | MB/SB - | 24.1 | |||
3.2/11.5 |
Author | Randomization | Stent | Technique | Number of Patients | Follow-Up (Months) | Restenosis Rate, % | TLR (%) |
---|---|---|---|---|---|---|---|
Colombo | да | SES | S + S | 63 | 6 | 28 | 9.5 |
S + B | 22 | 18.7 | 4.5 | ||||
Pan | да | SES | S + S | 47 | 11 | 20 | 5 |
S + B | 44 | 7 | 2 | ||||
Ge | не | SES | S + S | 117 | 9 | 24 | 8.9 |
S + B | 57 | 10 | 5.4 | ||||
Ge | не | SES + PES | S+ S | 181 | 9 | MB—11.5 | 14.9 |
SB—21.6 | |||||||
Sharma | не | SES | S+ S | 200 | 8 | 4 | |
Hoye | не | SES + PES | S+ S | 23 | 9 | MB—18.8 | 5.3 |
SB—12.5 | |||||||
Hoye | не | SES + PES | S+ S | 231 | 9 | MB—9.1 | 9.7 |
SB—25.3 | |||||||
Ge | не | SES + PES | S + S − T | 61 | 12 | 13 | 11.1 |
S + S − CR | 121 | 16.2 | 14 | ||||
Moussa | не | SES | S + S − CR | 120 | 6 | 11.3 | 11.3 |
Steigen | да | SES | S + S | 206 | 8 | MB/SB – | 1.0 |
5.1/11.5 | |||||||
S + B | 207 | MB/SB – | 1.9 | ||||
4.6/19.2 | |||||||
Ferenc | да | SES | S + B + S | 101 | 12 | MB/SB – | 10.9 |
7.3/7.3 | |||||||
S + S − T | 101 | MB/SB – | 8.9 | ||||
3.2/11.5 | |||||||
De Mario | не | PES | S + S | 118 | 12 | 16.5 | 18.3 |
S + B | 32 | 13.1 | 21 |
Study | Design | Patients, n KBI Non-KBI | Follow-Up (Months) | CVD KBI vs. Non-KBI | MI | TVR | Stent Thrombosis | MACE | SB Stenosis, % | |
---|---|---|---|---|---|---|---|---|---|---|
Provisional stenting | ||||||||||
THUEBIS | Random-ized | 56 | 54 | 6 | 0% vs. 3.7% | 3.6% vs. 1.9% | 18% vs. 15% | 3.6% vs. 1.9% | 23.2% vs. 24.1% | 37% vs. 32% |
Nordic III | Random-ized | 238 | 239 | 6 | 0.8% vs. 0% | 0.4–1.3% | 1.3% vs. 1.7% | 0.4% vs. 0.4% | 2.1% vs. 2.5% | 25% vs. 30% |
COBIS | Registry | 736 | 329 | 22 | 0.9–0.7% | 0.6–1.3% | 9.1–3.4% | NA | 10–4.9% | NA |
Yamawaki et al. [79] | Registry | 132 | 124 | 36 | 0–0.1% | 0–0% | 12–5% | 0–0% | 15–7% | NA |
Two stents | ||||||||||
Ge et al. [77] | Observa-tional | 116 | 65 | 9 | 1.7–0% | 10–14% | 9.5–24.6% | 2.6–3.1% | 20–39% | 24–38% |
Grundeken et al. [76] | Registry | 624 | 121 | 12 | 1.7–4.6% | 5.0–4.6% | 4.7–2.9% | 0.3–0.9% | NA | NA |
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Panayotov, P.; Mileva, N.; Vassilev, D. Current Challenges in Coronary Bifurcation Interventions. Medicina 2024, 60, 1439. https://doi.org/10.3390/medicina60091439
Panayotov P, Mileva N, Vassilev D. Current Challenges in Coronary Bifurcation Interventions. Medicina. 2024; 60(9):1439. https://doi.org/10.3390/medicina60091439
Chicago/Turabian StylePanayotov, Panayot, Niya Mileva, and Dobrin Vassilev. 2024. "Current Challenges in Coronary Bifurcation Interventions" Medicina 60, no. 9: 1439. https://doi.org/10.3390/medicina60091439