GAO Zhan， YANG Yue-jin， XU Bo， CHEN Ji-lin， QIAO Shu-bin， YAO Min， CHEN Jue， WU Yong-jian， LIU Hai-bo， DAI Jun， YUAN Jin-qing， LI Jian-jun， GAO Run-lin

Department of Cardiology， Cardiovascular Institute & Fuwai Hospital， Chinese Academy of Medical Sciences & Peking Union Medical College， Beijing 100037， China

Keywords: percutaneous coronary intervention•drug eluting stent•bifurcation

Abstract:

Background  Recently， several randomized and controlled trials have demonstrated great advantages of drug eluting stent (DES) with respect to significant reduction of restenosis and recurrence of symptoms and improvement of clinical outcomes after PCI. Little is known about the comparative effects of one DES plus kissing balloon technique with two DES for bifurcation angioplasty in Chinese population.
Methods  From April 2004 to June 2006， 566 consecutive Chinese patients underwent DES  implantation for true bifurcation lesions including 346 one DES with kissing balloon technique (3OO male， 57.7±11.5 years old) and 220 two DES (183 male， 58.1±10.7 years old) were analyzed. Clinical and angiographic follow-up was performed at 7 months.
Results  Major adverse cardiac events (MACE) rate was higher in two DES group than one DES group (5.5% vs 2.0%; p=0.032)， which was mainly contributed by acute myocardial infarction (AMI) (4.5% vs 1.4%; p=0.032) rather than death and target lesion revascularization (TLR) (0% vs 0.5; p=0.389 and 1.4% vs 2.7%; p=0.352). Stent thrombosis rate was higher in two DES group than one DES group (0.6% vs 2.7%; p=0.042)， except for one late stent thrombosis in two DES group， all of them were subacute stent thrombosis (2 in one DES group and 5 in two DES group). 7 months Angiographic follow-up rate was 36.4%. In main branch there was no difference of restenosis rate in one DES group compared with two DES group (9.8% vs 11.9%; p=0.652)， but in side branch the restenosis rate was higher in one DES group (33.6% vs 15.5%; p=0.004)， however， there was no difference of in-segment late loss between two groups either in main branch or in side branch.
Conclusion  Compared with two DES strategy， if final kissing balloon could be achieved， one DES strategy maybe more efficient and safe.