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Provisional T‐stenting and kissing balloon in the treatment of coronary bifurcation lesions: Results of the French multicenter “TULIPE” study
Author(s) -
Brunel Philippe,
Lefevre Thierry,
Darremont Olivier,
louvard Yves
Publication year - 2006
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20800
Subject(s) - medicine , balloon , stent , angioplasty , stenosis , ejection fraction , cardiology , main branch , revascularization , surgery , canadian cardiovascular society , target lesion , intravascular ultrasound , radiology , percutaneous coronary intervention , heart failure , myocardial infarction , angina , business administration , business
Background : In previous prospective studies, a strategy of (a) stenting of the main branch, (b) provisional T‐stenting of the side branch, and (c) final kissing balloon inflation, was associated with high success and low target lesion revascularization (TLR) rates on the long‐term.Objectives : To examine the performance of this strategy in a multicenter study.Methods : Consecutive patients were treated at 14 French medical centers for de novo coronary bifurcation lesions with the same technique used. Immediate results and clinically‐driven TLR at 7 months were examined.Results : The mean reference diameters of the main and side branches were 3.2 ± 0.6 mm and 2.4 ± 0.5 mm, respectively. The side branch was stented in 34% of patients. A <30% residual stenosis in the main branch was achieved in 99%, <50% in the side branch in 90%, and both in 89% of procedures. The in‐hospital major adverse cardiovascular event were a Q‐wave and 5 non‐Qwaves MI (0.54% and 2.7%). At 7 months of follow‐up, 3 patients (1.76%) had died, 1 suffered a non‐Q‐wave MI (0.59%), and 28 (15.88%) underwent TLR. By multivariate analysis, a lower left ventricular ejection fraction (OR: 0.934), moderate calcifications (OR: 7.86), and non‐use of the “jailed” wire technique (OR: 4.26) were associated with reinterventions during follow‐up.Conclusions : A strategy of provisional T‐stenting with a tubular stent and final kissing balloon angioplasty for the treatment of coronary bifurcation lesions was safe and associated with a low TLR rate at 7 months. This strategy should be applicable to the new era of drug eluting stents. © 2006 Wiley‐Liss, Inc.