Impact of Side Branch Predilatation on Provisional Bifurcation Percutaneous Coronary Intervention Outcomes: Insights From PROGRESS-BIFURCATION Registry.

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions Pub Date : 2025-02-24 DOI:10.1002/ccd.31465

Pedro E P Carvalho, Deniz Mutlu, Dimitrios Strepkos, Michaella Alexandrou, Ozgur Selim Ser, Sandeep Jalli, Barkin Kultursay, Ali Karagoz, Oleg Krestyaninov, Dmitrii Khelimskii, Mahmut Uluganyan, Korhan Soylu, Ufuk Yildirim, Olga Mastrodemos, Bavana V Rangan, Konstantinos Voudris, M Nicholas Burke, Yader Sandoval, Emmanouil S Brilakis

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引用次数: 0

Abstract

Background: Whether side branch (SB) predilatation should be performed in patients undergoing bifurcation percutaneous coronary interventions (PCI) remains controversial.

Methods: We performed an observational cohort study across six international centers from 2013 to 2024, as part of the Prospective Global Registry of PCI in Bifurcation Lesions (PROGRESS-BIFURCATION). We analyzed procedural characteristics and in-hospital outcomes of patients undergoing provisional bifurcation PCI with and without SB lesion predilatation. Significant SB lesions were defined as those with ≥50% diameter stenosis. Multivariable adjusted hazard ratios (aHR) with 95% confidence intervals [CI] were calculated using mixed effects Cox regression.

Results: Of 1042 lesions treated with provisional bifurcation PCI, 428 (41.1%) had significant SB lesions (true bifurcation lesions). Among these, 143 (33.4%) underwent predilatation. Lesions that underwent SB predilatation had longer SB lesion length (median 10.0 mm [IQR 5.0-10.0] vs. 5.0 mm [IQR 5.0-10.0], p = 0.001) and more SB diameter stenosis (median 90% [IQR 70%-95%] vs. 70% [IQR 60-90]). Technical success (95.1% vs. 87.7%; p = 0.015) and procedural success (93.7% vs. 82.8%; p = 0.003) were more common in the SB predilatation group, although the rates of crossover to a 2-stent technique were also higher in the SB predilatation group (23.1% vs. 10.9%; p < 0.001). The incidence of procedural complications (22.3% vs. 21.3%, p = 0.897) and in-hospital major adverse cardiovascular events (2.4% vs. 6.4%, p = 0.097) was similar between the groups.

Conclusion: In provisional bifurcation PCI of true bifurcation lesions, SB predilatation was performed in approximately one-third and was associated with higher technical and procedural success, higher rates to crossover to a 2-stent technique, and similar incidence of in-hospital and long-term follow-up outcomes.

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.