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Simple Stenting Best for Coronary Artery Bifurcation

Procedure produces excellent clinical and angiographic results

FRIDAY, Oct. 27 (HealthDay News) -- Treating de novo coronary artery bifurcation lesions with sirolimus-eluting stents (SES) produces excellent results, with a simple stenting strategy associated with reduced times for both the procedure and fluoroscopy, according to a report published online Oct. 23 in Circulation: Journal of the American Heart Association.

Leif Thuesen, M.D., of Aarhus University Hospital in Aarhus, Denmark, and colleagues conducted a study of 413 patients with bifurcation lesions who were randomized to receive either main vessel (MV) or main vessel and side branch (MV + SB) stenting with SES.

At the six-month mark, both groups produced similar rates of major adverse cardiac events: 3.4 percent for the MV + SB group versus 2.9 percent for the MV group. However, patients in the MV + SB group had significantly longer procedure and fluoroscopy times. Contrast volumes and procedure-related increases in biomarkers of myocardial injury were also higher in this group than in the MV group.

In total, 307 patients had a quantitative coronary assessment at the index procedure and at eight months. After eight months, the combined angiographic endpoint was similar in the two groups: 5.3 percent of the MV group and 5.1 percent of the MV + SB group had diameter stenosis of more than 50 percent of the main vessel and occlusion of the side branch.

"Independent of stenting strategy, the procedural success rates were high, the major adverse cardiac events rate low, and the angiographic restenosis rate low in both treatment groups," the authors conclude.

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