Treatment of non-left main bifurcation lesions using the sirolimus-eluting stent: A comparison of chronic outcomes of cross-over single stenting and crush stenting

Abstract

It is said that the chronic outcomes of the two-stent technique for bifurcation lesions are inferior to that of cross-over single stenting. However, there are many cases where true bifurcations are difficult to treat by single stenting and, in particular, strategies for bifurcation lesions that are not left main trunk (LMT) bifurcations are still not clear. This study aims to compare the usefulness of crush stenting with that of cross-over single stenting using the sirolimus-eluting stent (SES) on bifurcation lesions with the exclusion of LMT bifurcations. Subjects were 92 consecutive patients (100 lesions) who underwent cross-over single stenting or crush stenting using SES for bifurcation lesions with the exclusion of LMT bifurcations. The patients were divided into 33 patients with 34 lesions, in whom the stent was implanted in the main vessel alone with the kissing balloon technique performed for the main vessel and side branch (Single-stenting group; S group), and 59 patients with 66 lesions, in whom the stent was implanted through crush stenting (Crush-stenting group; C group). The two groups were compared for target lesion revascularization (TLR) and major adverse cardiac events (MACE). There were no differences for TLR, with this conducted in the main vessel in 5.9% of S group and 4.5% of C group. There was no difference between the groups in MACE with 9.1% in S group and 8.5% in C group. No significant difference was seen in MACE-free survival rate in the chronic phase with 93.9% for S group and 94.9% for C group (P=NS). No differences in chronic clinical outcomes were revealed in a comparison between cross-over single stenting and crush stenting. Good clinical outcomes were achieved by both cross-over single stenting and crush stenting in the treatment of non-left main bifurcation lesions.