Can "true bifurcation lesion" actually be regarded as an independent risk factor of acute side branch occlusion after main vessel stenting?: A retrospective analysis of 1,200 consecutive bifurcation lesions in a single center.

Abstract

True bifurcation lesion (TBL) is conventionally considered as a risk factor for acute side branch (SB) occlusion when using a single-stent strategy to treat bifurcation lesions. The impact of TBLs on acute SB occlusion after main vessel (MV) stenting was investigated. A total of 1,170 consecutive patients with 1,200 bifurcation lesions undergoing one-stent or provisional two-stent techniques were studied. The TBLs were divided into two groups depending on their Medina classification. Multivariate logistic regression analysis was performed to identify independent predictors of acute SB occlusion. According to the median diameter of stenosis (DS) in the MV and the SB after pre-dilatation, the TBL group was divided into three subgroups: subgroup I (DS of both the MV and the SB <their respective medians), subgroup II (DS of one of the MV or the SB ≥its respective median), and subgroup III (DS of both the MV and the SB ≥their respective medians). The incidences of SB occlusion in these three subgroups were compared. Multivariate logistic regression analysis showed that TBL occurrence was not independently predictive of SB occlusion. Based on subgroup analysis, the incidence of SB occlusion in subgroup I (7.4%) was significantly lower than that in subgroup II (13.0%) and subgroup III (22.0%) (P = 0.025). However, there was no significant difference in the incidence of SB occlusion between TBL subgroup I (7.4%) and the non-TBL group (5.1%) (P = 0.53). TBL occurrence cannot be regarded as an independent predictor of acute SB occlusion after MV stenting.