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Provisional T-stenting And Small Protrusion Technique for Bifurcation Lesion: Mid-term Follow-up Results
성균관대학교 의과대학 삼성서울병원 심장혈관센터
권현철, 송영빈, 김준형, 한주용, 최진호, 최승혁, 이상훈, 홍경표, 박정의
Background: T-stenting And Small Protrusion (TAP) technique may improve the long-term result of bifurcation stenting by complete coverage of side branch ostium after main vessel stenting. Methods: This study is a single center prospective registry of provisional TAP technique using drug eluting stent; after main vessel stenting, a side branch stent was intentionally pulled back into the parent stent to cover the side branch ostium. Patients with a bifurcation lesion with side branch > 2.3 mm by visual assessment were included. The indication of side branch stenting was residual stenosis > 50% or any dissection in side branch. Results: Two hundred eleven lesions in 207 patients were included. Out of 211 lesions, 122 lesions (58%) stented both branches using TAP technique. Nine-month clinical follow-up was completed in 168 patients (100% of due follow-up period). Cardiac death was noted 3 patients (1.4%), target lesion revascularization (TLR) in 5 patients (2.4%), and target vessel revascularization (TVR) in 6 patients (2.9%). Nine-month angiographic follow-up was completed in 19 lesions in 118 patients. Restenosis was noted in 6 lesions (5.0%) in main vessel, in 8 lesions (6.7%) in side branch, and 11 lesions (5.2%) in any branch. Clinical event and angiographic restenosis rate was not significantly different between 1-stent and 2-stent groups. Conclusion: Provisional TAP technique is safe and effective strategy to treat coronary bifurcation lesion. Acceptable result was achieved both in 1-stent and 2-stent groups.
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