Short and intermediate term follow up of angina patients with true coronary bifurcation lesion treated by stenting the main branch only with or without initial balloon dilatation of the side branch

Abstract

Bifurcation stenosis is one of the most complex coronary lesions requiring

endovascular treatment because the lumen of both the main vessel and the side

branch needs to be restored. The best approach for the management of a bifurcation

to achieve optimal procedural outcomes and, more importantly, long-term success

with low restenosis rates and low major adverse clinical event (MACE) rates is still

debated. (Berger PB,et al.,2000)

True bifurcation lesions, representing up to 16% of coronary targets for intervention,

have been associated with higher peri-procedural complication rates and lower long-

term patency rates, In the contemporary interventional era, several approaches have

been proposed to treat bifurcation lesions, Coronary stents improve the immediate

angiographic results by reducing lesion recoil and achieving better scaffolding, but

stents are associated with increased thrombotic complications and later restenosis in

bifurcation lesions. (Moses JW,et al.,2004)

When compared with nonbifurcation coronary interventions, bifurcation

interventions have historically reported a lower rate of procedural success, higher

procedural costs, longer hospitalization, and higher clinical and angiographic

restenosis, Consequently, the treatment of coronory bifurcation lesions represents a

challenging area in interventional cardiology. However, recent advances in stent