PERCUTANEOUS INTERVENTION FOR CORONARY BIFURCATIONS-OUR EXPERIENCE ON 133 PATIENTS AT ARMY CARDIAC CENTRE LAHORE

Abstract

Objective: To study the safety and efficacy (pre and post procedure outcomes) ofstenting the main vessel (MV) with or without stenting the side branch (SB) in thetreatment of coronary bifurcation lesions.

Methodology: In this retrospective analysis of 133 patients, operated betweenOct 2009 and Sept 2010, true coronary bifurcation lesions using the registry atArmy Cardiac Centre were analyzed. All angiograms and case notes werereviewed for sites of lesions, MADINA classification, angle of bifurcation, size ofMV and of SB, number and type of stents used, total procedure and radiation time,and patient characteristics. In-hospital MACE events were recorded for allpatients.

Results: Of the 133 cases, 120 (90.2 %) underwent MV stenting alone, while13(9.8%) underwent SB stenting as well. Drug Eluting Stent (DES) with minicrushtechnique was deployed in the majority of the latter cases. In hospitalclinical follow up showed 2 NSTEMI in the SB stents (p=0.009) whereas noMACE event was recorded for MV stents alone.

Conclusion: Stenting of only MV is safer, effective and economical than stentingof both MV and SB. Moreover contrast related risks and risks of radiation aremuch less with stenting the MV in the treatment of coronary bifurcation ascompared to stenting of both MV and SB.