Differential Prognostic Impact of Treatment Strategies for LM Versus Non LM Bifurcation Lesion.

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain LM SESSION Differential Prognostic Impact of Treatment Strategies for LM Versus Non LM Bifurcation Lesion. Lessons from the COBIS Registries Author: Young Bin Song, MD, PhD, Samsung Medical Center, Korea Stent Technique (1-Stent vs. 2-Stent) The 1-stent strategy, if possible, should initially be considered the preferred approach for the tr eatment of coronary bifurcation lesions, especially LM bifurcation lesions. Clinical Outcomes Between LM VS Non-LM Patients with LM bifurcation showed significantly higher risks of target lesion failure, cardiac d eath or myocardial infarction, and target lesion revascularization compared to those with non-L M bifurcation. CONCLUSION & SUMMARY Patients treated with PCI for an LM bifurcation lesion had poorer outcomes than those with a non-LM bifurcation lesion in the era of second-generation DES. In the treatment of LM bifurcation, the 2-stent strategy was associated with a higher risk of T LF than the 1-stent strategy, mainly driven by higher risk of TLR; however, incidence of cardiac death or MI was not different between the strategies, unlike previous results from the COBIS II registry. In the treatment of a non-LM bifurcation, there were no significant differences in TLF, cardiac death or MI, and TLR between the 1-stent and 2-stent strategy groups.

Outcome After One Stent Technique in Bifurcation

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain NEWS 2 Outcome After One Stent Technique in Bifurcation: SB Strut Opening VS. Leave Alone Author: Chang-Wook Nam, MD, PhD, Keimyung University Dongsan Hospital, Korea PURPOSE OF THE CURRENT STUDY The aim of the current study is to evaluate the long-term clinical outcome according to SB opening procedure of bifurcation lesion after 1-stent crossover technique from COBIS 3 registry. LIMITATIONS Not free from selection bias as an observational study. Additional imaging study may have provided more information on the plaque progression The number of patients and events was too small to properly adjust for an adequate statistical power. The duration of a dual antiplatelet therapy for these higher- risk patients is still controversial SUMMARY There is the improvement of acute angiographic result in SB opening after simple crossover stenting. However, SB opening after simple crossover stenting did not show improvement in long-term clinical outcome compared to leave alone after simple crossover stenting. In addition, in both left main and true bifurcation, the simple crossover wit h additional SB opening did not showed a better long-term clinical outcome. Therefore, routine KBT after simple crossover may not be recommended. Provisional approach with FFR guidance will help to select the patients who need additional complex bifurcation procedure.

Critical analysis of 1 vs 2 stents in EXCEL Trial and more

European Bifurcation Club 2018 - EBC 2018 - Brussels, Belgium LM PCI techniques and results Critical analysis of 1 vs 2 stents in EXCEL Trial and more Author: I Sheiban, Interventional Cardiology P. Pederzoli Hospital Peschiera ( Verona ) / Italy