• Young-Hak Kim, Jae-Hwan Lee, Jae-Hyung Roh, Jung-Min Ahn, Sung-Han Yoon, Duk-Woo Park, Jong-Young Lee, Sung-Cheol Yun, Soo-Jin Kang, Seung-Whan Lee, Cheol Whan Lee, Ki Bae Seung, Won-Yong Shin, Nae-Hee Lee, Bong-Ki Lee, Sang-Gon Lee, Chang-Wook Nam, Junghan Yoon, Joo-Young Yang, Min-Su Hyon, Keun Lee, Jae-Sik Jang, Hyun-Sook Kim, Seong-Wook Park, and Seung-Jung Park.
• Division of Cardiology, Asan Medical Center, Seoul, South Korea.
• JACC Cardiovasc Interv. 2015 Apr 20; 8 (4): 550-60.

ObjectivesThis study sought to evaluate the optimal percutaneous coronary intervention techniques using drug-eluting stents for bifurcation coronary lesions.BackgroundThe optimal bifurcation stenting technique needs to be evaluated.MethodsThe trial included 2 randomization studies separated by the presence of side branch (SB) stenosis for patients having non-left main bifurcation lesions. For 306 patients without SB stenosis, the routine final kissing balloon or leave-alone approaches were compared. Another randomization study compared the crush or single-stent approaches for 419 patients with SB stenosis.ResultsBetween the routine final kissing balloon and leave-alone groups for nondiseased SB lesions, angiographic restenosis occurred in 17.9% versus 9.3% (p=0.064), comprising 15.1% versus 3.7% for the main branch (p=0.004) and 2.8% versus 5.6% for the SB (p=0.50) from 214 patients (69.9%) receiving 8-month angiographic follow-up. Incidence of major adverse cardiac events including death, myocardial infarction, or target vessel revascularization over 1 year was 14.0% versus 11.6% between the routine final kissing balloon and leave-alone groups (p=0.57). In another randomization study for diseased SB lesions, 28.2% in the single-stent group received SB stents. From 300 patients (71.6%) receiving angiographic follow-up, between the crush and single-stent groups, angiographic restenosis rate was 8.4% versus 11.0% (p=0.44), comprising 5.2% versus 4.8% for the main branch (p=0.90) and 3.9% versus 8.3% for the SB (p=0.12). One-year major adverse cardiac events rate between the crush and single-stent groups was 17.9% versus 18.5% (p=0.84).ConclusionsAngiographic and clinical outcomes were excellent after percutaneous coronary intervention using drug-eluting stents with any stent technique for non-left main bifurcation lesions once the procedure was performed successfully.Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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