Abstract
Introduction: Due to the high rate of restenosis, interventional therapy of bifurcation lesions (BIF – PCI) remains still a challenge. Many different strategies were used with unsatisfactory results in recent years. Objectives: Since very promising studies with drug eluting balloons (DEB) were reported in respect of restenosis, we studied the outcome of patients (PTS) who had been treated by deployment of a drug eluting stent (DES) in the main branch (MB) in combination with a DEB in the side branch (SB). Methods: We analyzed prospectively the outcome of our first 53 consecutive PTS with BIF – PCI, except left main – BIF-PCI, (40 men and 13 women, mean age 74 years) treated in our institution from Nov. 2009 till Dec. 2012 with the DES (Xience V , Abbot Vascular, USA) in MB and DEB (Sequent Please , B. Braun Melsungen, Germany) in SB (n 1⁄4 42 (79%) LAD-, n 1⁄4 6 (11%) CXand n 1⁄4 5 (10%) RCA– BIF – PCI). After 6 – 9 months either control coronary angiography was performed (40 PTS, 76%) or clinical outcome was completed (13 PTS, 24%). Results: In the control angiography we found restenosis of 50% with a need of clinically driven target lesion revascularization in only 1 PTS in SB (TLR rate 1,8%) and in 2 PTS in MB (TLR rate 3,7%). All restenoses we found in LAD – BIF. Since 1 PTS died 6 months after BIF-PCI (cause of death unknown), MACE rate was 5,7%. Conclusion: The BIF PCI strategy “DES in MB and DEB in SB” is safe and highly effective in real life conditions. Randomized studies with larger groups of PTS are mandatory to confirm these preliminary results. Disclosure of Interest: None Declared
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