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.
European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain NEWS 3 Keynote lecture: Lessons learned from COBIS studies: 2004 to 2019 Author: Bon Kwon Koo, MD, PhD & Young Bin Song, MD, PhD, Seoul National University Hospital, Samsung Medical Center, Seoul, Korea WHAT MAKES THE DIFFERENCE? Safer access: More trans-radial approach Better stents and better stenting technique Better PCI technique: Better kissing, NC balloon.... Better concept: Imaging guidance, SB relevance Better risk stratification: SB occlusion, risk stratification CONCLUSION COBIS registry started with bifurcation PCI patients since 2004 are s till ongoing with dedicated QCA core laboratory/CRO, independent st atistical analysis team and event adjudication committee. Results of COBIS studies expanded our knowledge on bifurcation tr eatment and improved the patients’ clinical outcomes. Ongoing COBIS III study will provide more insights on coronary bifu rcation lesions and their treatment.
European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain NEWS 2 Trend of Bifurcation PCI from COBIS I to COBIS III Author: Joon Hyung Doh, MD, PhD, Inje University Ilsan Paik Hospital, Goyang, Korea & Ki Hong Choi, MD, Samsung Medical Center, Seoul, Korea CONTEXT Trend of Bifurcation PCI in Korea using COBIS I, COBIS II, and COBIS III Registries Comparison of Inclusion Criteria and Baseline Characteristics Changes of Treatment Strategies Comparison of Follow-up Clinical Outcomes SUMMARY From COBIS I to COBIS III, left main bifurcation PCI is increasing. 1-stent strategy is still the most preferred technique (81.5% in COBIS III), even in LM bifurcation PCI. Among various 2-stenting techniques, the ‘crush technique’ is the most commonly used in Korea. The use of IVUS and trans-radial intervention are also on the rise in patients under went PCI with bifurcation lesion. Although proportion of FKB was reduced in COBIS III (compared with COBIS II), th e concept of POT have been newly developed and widely used. From COBIS I to COBIS III, the incidence of MACE (cardiac death, MI, and TLR) tren d toward to decrease in real world bifurcation PCI.