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ȣ - 480083 191 |
The Early Result of TAXUS Kissing Stenting in the Bifurcation Lesion |
¹ Sungkyunkwan University School of Medicine, ² Ulsan University Asan Medical Center, ³ Yonsei University College of Medicine |
Hyeon-Cheol Gwon¹, Myung Ki Hong², Yang Soo Jang³ |
Background: The bifurcation lesion is still associated with high restenosis rate particularly in the side branch ostium even in the era of drug-eluting stent. Kissing stent technique may be associated with better outcome in the bifurcation lesion.
Methods: Thirty-two patients from 3 center were prospectively included in this prospective registry of kissing stenting with TAXUS stent (Boston, USA) in the bifurcation lesion. Inclusion criteria were type 1, 2 or 4 bifurcation lesion with reference vessel diameter 2.5 – 3.5 mm and lesion length 24 mm. ST-elevation myocardial infarction within 48 hour of onset and instent restenosis were excluded. Aspirin and clopidogrel were loaded before procedure and continued for 9 months.
Results: The diagnosis of 9 patients were acute coronary syndrome. Eleven patients were diabetics. Left main bifurcations were 12 patients, left anterior descending artery 16 patients, left circumflex 3 patients and right coronary artery1 patient. Twenty eight cases were type 1 lesions (88%). Intravascular ultrasound was performed in 22 patients. Minimal luminal area after angioplasty was 6.81.4 mm2 in main and 6.82.7 mm2 in side branch. Creatine kinase-MB fraction level more than 3 times of normal value was noted in 3 patients. Subacute thrombosis developed in 2 patients during hospitalization, one of whom died.
Conclusions: The kissing stent technique using TAXUS stent for the true bifurcation lesion was feasible and associated with large luminal gain in the side branch. The result of long-term follow-up will be presented.
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Pre-RD |
Pre-MLD |
Length |
Post-RD |
Post-MLD |
Main
branch (mm) |
3.2±0.6 |
0.8±0.6 |
13.8±7.3 |
3.5±0.7 |
2.7±0.5 |
Side
branch (mm) |
2.7±0.8 |
0.9±0.5 |
9.0±6.3 |
3.0±0.7 |
2.5±0.6 |
(RD = reference diameter, MLD = minimal
luminal diameter)
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