| 정종원, 안영근, 홍영준, 윤남식, 윤현주, 문재연, 김계훈, 박형욱, 김주한, 정명호, 조정관, 박종춘, 강정채 |
Background: Although drug-eluting stent placement for MV with dedicated techniques has been suggested to be a useful therapeutic modality for bifurcation lesions, limited information is available whether which treatment modality provides any advantage for TLR for MV or SB. The purpose of this study was to evaluate the impact of treatment modality for coronary bifurcation lesions on target lesion revascularization (TLR) for the main vessel (MV) or side branch (SB).
Methods: Between January 2004 and June 2006, we treated a total of 175 patients with bifurcation lesions with DES placement for MV [paclitaxel-eluting stent (PES); n=90, sirolimus-eluting stent (SES); n=85] with various treatment modality for SB intervention [Group I; DES placement (n=37), Group II; bare-metal stent placement (n=14), Group III; balloon angioplasty (n=70), and Group IV; no intervention (n=54)]. We observed six-month follow-up TLR for MV or SB.
Results: TLR for MV was performed in 8.1% (3/37) in Group I, 0% (0/14) in Group II, 11.4% (8/70) in Group III, and 1.9% (1/53) in Group IV, and TLR for SB was performed in 13.5% (5/37) in Group I, 0% (0/14) in Group II, 5.7% (4/70) in Group III, and 1.9% (1/53) in Group IV. In Group I, TLR for MV was performed in 4.2% (1/24) in PES group and in 15.4% (2/13) in SES group (p=0.233), and TLR for SB was performed in 4.2% (1/24) in PES group and in 30.8% (4/13) in SES group (p=0.023). In Group II, no TLR for MV and SB was performed in both PES and SES group. In Group III, TLR for MV was performed in 20% (6/30) in PES group and in 5% (2/40) in SES group (p=0.088), and TLR for SB was performed in 6.7% (2/30) in PES group and in 5% (2/40) in SES group (p=0.484). In Group IV, TLR for MV was performed in 4% (1/25) in PES group and in 0% (0/29) in SES group (p=0.277), and TLR for SB was performed in 4% (1/25) in PES group and in 0% (0/29) (p=0.277).
Conclusion: Simpler strategy of drug-eluting stent implantation for only the main vessel shows similar outcome compared with a complex strategy for the treatment of true bifurcation lesions.
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