3-year follow-up of 100 consecutive coronary bifurcation lesions treated with Taxus stents and the crush technique

Autor: Jonathan N. Townend, Sagar N. Doshi, Andrew C R Epstein, Peter Ludman, Nigel P. Buller, Helen Routledge, Colin D. Chue
Rok vydání: 2010
Předmět:
Target lesion
Male
Time Factors
medicine.medical_treatment
Abciximab
Myocardial Infarction
Infarction
Coronary Artery Disease
Kaplan-Meier Estimate
Single Center
Balloon
Restenosis
Prospective Studies
Registries
Angioplasty
Balloon
Coronary
Aged
80 and over
Antibodies
Monoclonal
Drug-Eluting Stents
General Medicine
Middle Aged
surgical procedures
operative
Treatment Outcome
England
Female
Radiology
Cardiology and Cardiovascular Medicine
medicine.drug
Adult
medicine.medical_specialty
Paclitaxel
Prosthesis Design
Risk Assessment
Disease-Free Survival
Immunoglobulin Fab Fragments
Angioplasty
medicine
Humans
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
Aged
Chi-Square Distribution
business.industry
Patient Selection
Stent
Cardiovascular Agents
Thrombosis
equipment and supplies
medicine.disease
Surgery
business
Platelet Aggregation Inhibitors
Follow-Up Studies
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions. 75(4)
ISSN: 1522-726X
Popis: Objectives: To determine the 3 year safety and efficacy of crush-stenting with paclitaxel-eluting stents. Background: The optimum two-stent strategy for treatment of coronary bifurcation lesions is undetermined. Crush-stenting is advocated to minimize restenosis through complete circumferential stent coverage; long-term follow-up data are lacking. Methods and Results: In a single center prospective registry, 100 consecutive patients with bifurcation lesions were treated with the Crush technique. The vast majority (93%) were true bifurcations, predominantly involving the left anterior descending and diagonal arteries. Technical success was 98%. Final kissing balloon dilatation, which became standard practice during the study, was attempted in 68 patients and successful in 51. Abciximab was used in all cases. There were no peri-procedural stent thromboses. Follow-up was 100% at 3 years. Symptom-driven target lesion revascularisation was 8% at 3 years. Cumulative 3-year major adverse cardiac events was 28% (7 cardiac deaths, 15 myocardial infarctions, 11 target vessel revascularisations). Absence of a final kissing inflation predicted repeat revascularisation but not death, infarction or stent thrombosis. Three probable stent thromboses occurred, of which two were very late. Conclusion: Where a two-stent bifurcation strategy is required, Crush-stenting with paclitaxel-eluting stents is safe and effective in the long-term. Failure to perform a final kissing dilatation increases the likelihood of revascularisation but not other adverse events. © 2009 Wiley-Liss, Inc.
Databáze: OpenAIRE
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