Angiographic result of T-stenting with small protrusion using drug-eluting stents in the management of ischemic side branch: the ARTEMIS study

Heart Vessels. 2015 Jul;30(4):427-31. doi: 10.1007/s00380-014-0492-9. Epub 2014 Mar 14.

Abstract

The aim of this study was to examine the mid-term angiographic result of T-stenting with small protrusion (TAP) as the bailout strategy for treating coronary bifurcation lesions. From 2009 to 2012, symptomatic patients who had severe coronary bifurcation stenoses were treated with one-stent strategy using drug-eluting stents, with kissing balloon inflation performed whenever side branch (SB) impingement occurred. TAP was performed if residual diameter stenosis of SB was ≥75%, presence of ≥type B dissection or flow impairment was observed in the SB. Seventy-one patients (83% male, mean age of 61 ± 12 years) were recruited into the study. MEDINA classification 1,1,1 lesions were observed in over 60% of patients. The mean stent size and length in the main vessel (MV) and SB were 2.86 ± 0.43 and 30 ± 12, and 2.45 ± 0.26 and 16 ± 6 mm, respectively. Restudy angiography was performed on 64 (90 %) patients at 9.2 ± 3.9 months. Angiographic restenosis was observed in 8 (12.5%) patients with late lumen loss in the MV and SB being 0.22 ± 0.19 and 0.34 ± 0.37 mm, respectively. The use of TAP as the bailout technique for treating coronary bifurcation lesions is associated with good angiographic outcomes, in terms of late lumen loss and restenosis, at 9 months.

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Coronary Angiography
  • Coronary Artery Disease / therapy*
  • Coronary Restenosis / diagnostic imaging*
  • Coronary Restenosis / therapy*
  • Coronary Vessels / diagnostic imaging*
  • Drug-Eluting Stents*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / etiology*
  • Prosthesis Design
  • Treatment Outcome