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Войти в исследования Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese · 2026
Long-term outcomes after ostial stenting for 0.0.1 and 0.1.0 coronary bifurcation lesions. Results from the real-world multicenter registry.
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Khelimskii Dmitrii, Bessonov Ivan, Kashtanov Maksim, Sapozhnikov Stanislav, Utegenov Ruslan, Manukian Serezha, Badoian Aram, Baranov Aleksey, Krestyaninov Oleg
Аннотация
BACKGROUND: Although cross-over stenting (CS) remains the gold standard for treating most bifurcation lesions, ostial stenting (OS) may be considered for patients with favorable anatomy. The aim of this study was to evaluate outcomes after OS vs. CS in patients with 0.1.0 and 0.0.1 bifurcation lesions.
METHODS: A total of 790 patients who underwent PCI for 0.1.0 and 0.0.1 lesions and had clinical follow-up were included in the analysis. The patients were divided into an OS group (n = 186) and CS group (n = 604). An inverse probability treatment weighting model was used to assess long-term outcomes.
RESULTS: OS was more often performed in patients with left main disease (52% vs. 31%, p < 0.001). Patients in the OS group more often had calcification (23% vs. 15%, p = 0.026) and thrombosis (11% vs. 6.5%, p = 0.044). The occurrence of residual dissection was significantly lower in the OS group (0.2% vs. 3.1%, p = 0.007) in addition to disturbance of blood flow in the SB after stent implantation (0.5% vs. 3.2% p = 0.007). The median follow-up was 1504 days. There were no significant differences in the major adverse cardiac events (MACE) between groups (18.9% vs. 22.2%, p = 0.331). However, a lower rate of target vessel revascularization (TVR) was observed in the OS group (2.4% vs. 0.5%, p = 0.046).
CONCLUSIONS: In patients with 0.0.1 and 0.1.0 bifurcation lesions, OS was associated with less residual stenosis and lower incidence of blood flow disturbance in the SB after stent implantation, and a lower incidence of TVR at follow-up than was the CS, but this finding was not accompanied by a reduction in the rates of MACE.
METHODS: A total of 790 patients who underwent PCI for 0.1.0 and 0.0.1 lesions and had clinical follow-up were included in the analysis. The patients were divided into an OS group (n = 186) and CS group (n = 604). An inverse probability treatment weighting model was used to assess long-term outcomes.
RESULTS: OS was more often performed in patients with left main disease (52% vs. 31%, p < 0.001). Patients in the OS group more often had calcification (23% vs. 15%, p = 0.026) and thrombosis (11% vs. 6.5%, p = 0.044). The occurrence of residual dissection was significantly lower in the OS group (0.2% vs. 3.1%, p = 0.007) in addition to disturbance of blood flow in the SB after stent implantation (0.5% vs. 3.2% p = 0.007). The median follow-up was 1504 days. There were no significant differences in the major adverse cardiac events (MACE) between groups (18.9% vs. 22.2%, p = 0.331). However, a lower rate of target vessel revascularization (TVR) was observed in the OS group (2.4% vs. 0.5%, p = 0.046).
CONCLUSIONS: In patients with 0.0.1 and 0.1.0 bifurcation lesions, OS was associated with less residual stenosis and lower incidence of blood flow disturbance in the SB after stent implantation, and a lower incidence of TVR at follow-up than was the CS, but this finding was not accompanied by a reduction in the rates of MACE.