"Main Vessel-Oriented" Treatment Strategy Versus "Open Side Branch" Treatment Strategy in Acute Coronary Syndrome Patients With Culprit Bifurcation Lesions

被引：3
|
作者：
Tigen, Kursat [1 ]
Dogan, Zekeriya [1 ]
Sunbul, Murat [1 ]
Gurel, Emre [1 ]
Cincin, Altug [1 ]
Kanar, Batur [1 ]
Sayar, Nurten [1 ]
Ozben, Beste [1 ]
机构：
[1] Marmara Univ, Fac Med, Dept Cardiol, Istanbul, Turkiye
来源：
AMERICAN JOURNAL OF CARDIOLOGY | 2023年 / 204卷
关键词：
acute coronary syndromes; culprit bifurcation lesion; main vessel-oriented treatment strategy; side branch opening; LONG-TERM OUTCOMES; CLASSIFICATION; DISEASE;
D O I：
10.1016/j.amjcard.2023.07.132
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Percutaneous coronaryinterventionofbifurcationlesionsisassociatedwithanincreased risk ofcomplicationsinpatientswithacutecoronarysyndrome(ACS). Thestudyaimedto evaluate thein-hospitaloutcomesofpatientswithACSwithculpritbifurcationlesions who weretreatedwitheithera"mainvessel-oriented"(MVO) treatmentstrategyoran "open sidebranch"(OSB) treatmentstrategy. Thisretrospectivestudyincluded575consecutive patientswithACS."MVO" and"OSB" treatmentstrategiesweredefinedasprimary/urgent percutaneouscoronaryinterventionproceduresperformedbyeithertotally ignoring thesidebranch(SB) ortryingtomaintainbothmainvesselandSBopenwith thrombolysis inmyocardialinfarction3flow. Proceduralsuccessandmajorcardiac/cerebrovascular eventsduringhospitalizationwerenoted. MVOandOSBtreatmentstrategies were performedon384and191patients, respectively. Theproceduralsuccessratewas significantly higherintheOSBtreatmentstrategywhereasmajorcardiac/cerebrovascular events ratesweresimilarexceptforthecontrast-inducednephropathyratebeingslightly higher inOSBtreatmentstrategy. Subgroupanalysisrevealedasignificantlyhigherprocedural successrateinOSBtreatmentstrategyiftheSBwaslocatedwithinthebifurcation core, especiallyinthosewherethediameterofSBwas >= 2 mm. Inconclusion, ourresults suggest abetterproceduralresultwithSBprotectionattemptsinpatientswithACSwith a culpritbifurcationlesioniftheSBisoriginatingwithinthebifurcationcoreanditsdiameter is >= 2 mm. MVOtreatmentstrategymaybepreferredinmostcaseswithminorSBs located distanttothebifurcationcorebecauseofthesimilarproceduralsuccess. (c) 2023 Elsevier Inc. Allrightsreserved.(AmJCardiol2023;204:339-344)
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页码：339 / 344
页数：6
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