The following is a summary of “Clinical outcomes of single- versus two-stent PCI technique in severely calcified true bifurcation lesions after rotational atherectomy,” published in the June 2024 issue of Cardiology by Samy et al.
Treating severely calcified coronary bifurcations during percutaneous coronary interventions (PCI) is complicated and may need special dedicated lesion preparation.
Researchers conducted a retrospective study to determine whether using 1 stent or 2 stents after rotational atherectomy (RA) gives better results for these tough-to-treat bifurcation lesions.
They studied patients with severely calcified true bifurcations undergoing RA at 1 center, where 59 patients received 1 stent, and the other 59 got 2 stents. In-hospital adverse outcomes and 1-year rates of the bifurcation-oriented composite endpoint (BOCE), defined as cardiac death, target bifurcation myocardial infarction (TB-MI), or target bifurcation revascularization (TBR).
The results showed that the single-stent group had more in-hospital issues (aOR 6.13; 95% CI 1.34-28.0; P=0.019) due to higher peri-procedural MI rates (18.6% vs. 5.1%, P=0.043) and side branch problems (13.6% vs. 0%, P=0.006). Both techniques showed similar 1-year BOCE (aHR 0.38; 95% CI 0.12-1.23; P=0.106). Significant interaction between treatment technique and presence of LM bifurcation ( P interaction =0.012), stating single-stent was better for non-LM bifurcations (HR 0.14, 95% CI 0.03-0.68, P=0/015), with lower TBR rates (2% vs. 15%, P log-rank=0.026) after 1 year.
Investigators concluded that patients with severely calcified bifurcations treated with a single stent had more in-hospital issues. Still, the 2-stent method didn’t show better long-term outcomes and had higher revascularization rates after 1 year.
Source: link.springer.com/article/10.1007/s00392-024-02461-y
The post Outcomes of Single vs Two Stent PCI for Calcified True Bifurcation Lesions Following RA first appeared on Physician's Weekly.