The "-Sandwich" Strategy for True Coronary Bifurcation Lesions: A Randomized Clinical Trial.

Background: This study explored the efficacy of the "-sandwich" strategy, which involves the implantation of stents in the main vessel (MV) and shaft of the side branch (SB) with a drug-coated balloon (DCB) applied to the SB ostium, for coronary true bifurcation lesions.

Methods And Results: Of 99 patients with true bifurcation lesions, 38 patients underwent the "-sandwich" strategy (group ), 32 patients underwent a two-stent strategy (group ), and 29 patients underwent a single-stent + DCB strategy (group ). Angiography outcomes (late lumen loss [LLL], minimum lumen diameter [MLD]), and clinical outcomes (major adverse cardiac events [MACEs]) were analyzed. At 6 months, the MLD of the SB ostium in groups and were similar ( > 0.05) and group larger than group ( < 0.05). The LLL of group was the largest among the three groups ( < 0.05). The MLD of the SB shaft in groups and were larger than in group ( < 0.05). The LLL of the SB shaft in group was the lowest ( < 0.05). Two patients in group received target vessel revascularization at the 6-month followup ( > 0.05), and patients in the other groups had no MACEs.

Conclusions: The "-sandwich" strategy was feasible for the treatment of true coronary bifurcation lesions. It is a simpler procedure with similar acute lumen gain than the two-stent strategy, results in a larger SB lumen than the single-stent + DCB strategy, and it can also be used as a remedy for dissection following the single-stent + DCB strategy.