Background: The multicenter and randomized DEFINITION II (Two-Stent vs Provisional Stenting Techniques for Patients With Complex Coronary Bifurcation Lesions) trial showed less 1-year target lesion failure (TLF) after a 2-stent approach for complex coronary bifurcation lesions compared with provisional stenting (PS). The authors report the 3-year clinical outcome of the DEFINITION II trial.
Objectives: The aim of the present study was to investigate the difference in TLF at 3 years after a planned 2-stent approach vs PS for complex coronary bifurcation lesions stratified by DEFINITION (Definitions and Impact of Complex Bifurcation Lesions on Clinical Outcomes After Percutaneous Coronary Intervention Using Drug-Eluting Stents) criteria.
Methods: A total of 653 patients with complex coronary bifurcation lesions were randomly assigned to either the 2-stent group or the PS group in the DEFINITION II trial and were followed for 3 years. The primary endpoint was the occurrence of TLF at 3 years. Stent thrombosis was the safety endpoint.
Results: At 3 years, TLF had occurred in 52 patients (16.0%) in the PS group and in 34 (10.4%) patients in the 2-stent group (HR: 0.63; 95% CI: 0.41-0.97; P = 0.035), driven mainly by increased target vessel myocardial infarction (8.0% vs 3.7%; HR: 0.45; 95% CI: 0.23-0.89; P = 0.022) and target lesion revascularization (8.3% vs 4.3%; HR: 0.50; 95% CI: 0.26-0.96; P = 0.038). There was no difference in TLF between the 2 groups between year 1 and year 3.
Conclusions: For patients with complex coronary bifurcations who reach 1-year postprocedure without experiencing endpoint events, there is still a risk for future events. The type of procedure performed initially is no longer a future event risk determinant. (Two-Stent vs Provisional Stenting Techniques for Patients With Complex Coronary Bifurcation Lesions; NCT02284750).
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jcin.2022.05.026 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pre-distance assessment from radial artery to lower extremity arterial lesion.
Int J Cardiovasc Imaging
January 2025
Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Endovascular treatment (EVT) for patients with lower extremity artery disease is widely used as a less invasive alternative to surgical bypass. Recently, transradial artery intervention has gained popularity owing to its minimally invasive nature. The distance from the radial artery to the target vessel is critical for success; however, effective pre-assessment methods have not yet been established.
View Article and Find Full Text PDFIntegrated Single-Cell Analysis Revealed Novel Subpopulations of Foamy Macrophages in Human Atherosclerotic Plaques.
Biomolecules
December 2024
State Key Laboratory of Transvascular Implantation Devices, Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
Foam cell formation is a hallmark of atherosclerosis, yet the cellular complexity within foam cells in human plaques remains unexplored. Here, we integrate published single-cell RNA-sequencing, spatial transcriptomic, and chromatin accessibility sequencing datasets of human atherosclerotic lesions across eight distinct studies. Through this large-scale integration of patient-derived information, we identified foamy macrophages enriched for genes characteristic of the foamy signature.
View Article and Find Full Text PDFArticle Synopsis
- The "no-touch" technique allows for safe navigation of a guiding catheter during carotid artery stenting, especially in patients with complicated arterial lesions.
- A specially designed 4-Fr Newton-shaped catheter minimizes contact with stenotic lesions while advancing to the target area.
- In a study of eight procedures, this technique was successful in all cases, showing it can be effective for patients with tortuous anatomy and floating thrombi without causing complications.
Long-term Follow-up Optical Coherence Tomography Assessment of Primary Percutaneous Coronary Intervention for Unprotected Left Main.
Rev Cardiovasc Med
December 2024
Department of Cardiology, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Background: Elective unprotected left main (ULM) percutaneous coronary intervention (PCI) has long-term mortality rates comparable to surgical revascularization, thanks to advances in drug-eluting stent (DES) design, improved PCI techniques, and frequent use of intravascular imaging. However, urgent PCI of ULM culprit lesions remains associated with high in-hospital mortality and unfavourable long-term outcomes, including DES restenosis and stent thrombosis (ST). This analysis aimed to examine the long-term outcomes and healing of DES implanted in ULM during primary PCI using high-resolution optical coherence tomography (OCT) imaging.
View Article and Find Full Text PDFComposite outcomes of drug-coated balloon using in left main bifurcation lesions: a systematic review.
J Geriatr Cardiol
November 2024
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Background: Left main coronary bifurcation lesions account for 50% of left main coronary artery disease cases. Although a drug-coated balloon (DCB) has the advantages of immediate release of the drug to the arterial wall and no remaining struts, there is no conclusive evidence to support DCB use.
Methods & Results: We conducted a systematic review in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!