Optimal Strategy for Side Branch Stenting in Coronary Bifurcation Lesion
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Side branch ballooning and kissing ballooning were done if Thrombolysis In Myocardial Infarction (TIMI) flow <3 in the side branch after main vessel stenting in non-left main bifurcation (non-LM) subgroup, and diameter stenosis (DS) >75% in LM subgroup.
Side branch stenting was performed if TIMI flow <3 in the Side branch after ballooning in non-LM subgroup, and DS >50% or dissection in the Side branch after ballooning in LM subgroup.
Experimental: Aggressive strategy
Procedure: Aggressive strategy
Main vessel was performed.
Side branch ballooning and kissing ballooning were done if DS >75% in the side branch after main vessel stenting in non-LM subgroup, and DS >50% in LM subgroup.
Side branch stenting was performed if DS >50% in the side branch after ballooning in non-LM subgroup, and DS >30% or dissection in the side branch after ballooning in LM subgroup.
Target vessel failure (TVF) [ Time Frame: 12 months ]
composite of cardiac death, myocardial infarction, target vessel revascularization
Secondary Outcome Measures
Cardiac death [ Time Frame: 12 months ]
All deaths were considered cardiac unless a definite non-cardiac cause could be established.
Myocardial infarction (MI) [ Time Frame: 12 months ]
MI was defined as elevated cardiac enzymes (troponin or MB fraction of creatine kinase, CK-MB) more than the upper limit of the normal value with ischemic symptoms or electrocardiography findings indicative of ischemia that was not related to the index procedure.
Target vessel revascularization (TVR) [ Time Frame: 12 months ]
TVR was repeat revascularization of the target vessel by PCI or bypass graft surgery.
Target lesion revascularization (TLR) [ Time Frame: 12 months ]
TLR was defined as repeat PCI of the lesion within 5 mm of stent deployment or bypass graft surgery of the target vessel.
Stent thrombosis [ Time Frame: 12 months ]
Stent thrombosis was assessed based on the definitions of the Academic Research Consortium as definite, probable, or possible stent thrombosis.
Periprocedural enzyme elevation [ Time Frame: during the hospitalization ]
Periprocedural enzyme elevation was defined as a rise in CK-MB ≥3 times the upper normal limit after the index procedure.
the incidence of binary angiographic restenosis in the main branch and side branch [ Time Frame: 9 months ]
as measured by 9-month quantitative coronary analysis
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Ages Eligible for Study:
18 Years and older (Adult, Senior)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Parent vessel diameter stenosis > 75%
Parent vessel diameter stenosis 50% - 75% with angina and/or objective evidence of ischemia in the non-invasive stress test
The reference diameter of both branches more than 2.3 mm by visual estimation
ST-elevation myocardial infarction within 48 hours of symptom onset
Left ventricular dysfunction (echocardiographic left ventricular ejection fraction < 25%)
Patients who have to receive clopidogrel due to other conditions
Patients who have to receive warfarin, cilostazol or other antiplatelet therapy
Hypersensitivity to clopidogrel or aspirin
Expectant survival less than 1 year
Women who plan to become pregnant
Patients with bleeding diathesis (coagulopathy, thrombocytopenia or platelet dysfunction, Gastrointestinal or genitourinary bleeding within the prior 3 months)
Patients who are actively participating in another drug or device investigational study, which have not completed the primary endpoint follow-up period.