Long‐term clinical outcomes with the use of a modified provisional Jailed‐Balloon stenting technique for the treatment of nonleft main coronary bifurcation lesions. Issue 5 (30th July 2013)

• Record Type: Journal Article
• Authors: Depta, Jeremiah P.; Patel, Yogesh; Patel, Jayendrakumar S.; Novak, Eric; Yeung, Michael; Zajarias, Alan; Kurz, Howard I.; Lasala, John M.; Bach, Richard G.; Singh, Jasvindar
• Is Part Of: Catheterization and cardiovascular interventions. Volume 82:Issue 5(2013:Nov. 01)
• Page Start: E637
• Page End: E646
• Publication Date: 2013-07-30
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.24778
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd24778-sec-0001" sec-type="section"> <title>Objectives</title> <p>To assess the long‐term clinical outcomes associated with treatment of nonleft main coronary bifurcation lesions using a modified provisional jailed‐balloon technique (JBT).</p> </sec> <sec id="ccd24778-sec-0002" sec-type="section"> <title>Background</title> <p>Percutaneous coronary intervention (PCI) of bifurcation lesions is associated with a higher risk of adverse events, including the risk of side branch (SB) loss during main branch (MB) stenting.</p> </sec> <sec id="ccd24778-sec-0003" sec-type="section"> <title>Methods</title> <p>From 4/2003 to 8/2010, 406 patients with 424 nonleft main coronary bifurcation lesions underwent PCI with (<italic>n</italic> = 95) and without (<italic>n</italic> = 311) the use of JBT. Rates of SB loss and long term clinical outcomes [death, myocardial infarction (MI), and target lesion revascularization (TLR)] were compared between patients undergoing PCI with and without JBT using univariate and propensity score adjusted and matched analyses.</p> </sec> <sec id="ccd24778-sec-0004" sec-type="section"> <title>Results</title> <p>The majority of patients presented with acute coronary syndrome (63%) and 90% of lesions were Medina class 1, 1, 1. Patients were followed for a mean of 2.7 ± 2.1 years. After propensity score matching (<italic>n</italic> = 81 in each group), JBT was associated with a significantly lower composite rate of death, MI, or TLR (HR 0.22, 95% CI 0.06–0.76; <italic>P</italic> = 0.02) and TLR (HR 0.20, 95% 0.04–0.92; <italic>P</italic> = 0.04) compared with no JBT. Permanent SB loss was significantly lower in the JBT group compared with no JBT group (OR 0.22, 95% CI 0.10–0.49; <italic>P</italic> = 0.0001).</p> </sec> <sec id="ccd24778-sec-0005" sec-type="section"> <title>Conclusions</title> <p>The use of JBT for the treatment of nonleft main coronary bifurcation lesions was associated with significantly lower rates of SB loss and major adverse cardiac events at late follow‐up. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>