Insights from the Thoraxcenter DES

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European Bifurcation Club 2005, EBC 2005 – Bordeaux, France

DEBATE – Which approach for LM stenting with DES?

Which approach for LM stenting with DES? Insights from the Thoraxcenter DES

Author: Angela Hoye, MD, Castle Hill Hospital, UK

 

METHODOLOGY

  • As a policy, all elective patients presenting with significant (>50% by visual estimation) LM disease are evaluated by both interventional cardiologists and cardiac surgeons and the decision to opt for PCI or surgery is reached by consensus
  • The interventional strategy was left to the operator’s discretion
  • All patients were maintained on lifelong aspirin, with clopidogrel for 1 month in those treated with BMS, and 6 months for those treated with DES
  • MACE: death

CONCLUSION

  • Compared with historical data of bare metal stents, the adverse event rate is lower following DES implantation for LMS disease
  • The majority of adverse events occur within 1 year
  • The long-term angiographic outcome of the main vessel was not significantly affected whether or not the side branch was stented
  • The long-term angiographic outcome of non-stented side branches was similar to that of stented side branches
  • Both single stent and 2-stent strategies appear to be reasonable options for the therapy of distal LMS disease
  • There is unlikely to be a single strategy that is broadly applicable to all anatomies and lesion subtypes. Further research with randomised studies is needed to evaluate outcomes with respect to the strategy used for differing bifurcation lesions

 

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