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左主干末段分叉病变介入治 疗，对吻与否？ 南京市第一医院 南京市心血管医院 南京市心脏病研究所 林松 陈绍良

左主干末段分叉病变介入治 疗，对吻与否？ 南京市第一医院 南京市心血管医院 南京市心脏病研究所 林松 陈绍良. Randomized Comparison of Provisional Side Branch Stenting versus a Two-stent Strategy for treatment of True Coronary Bifurcation Lesions Involving a Large Side Branch. The Nordic-Baltic Bifurcation Study IV.

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左主干末段分叉病变介入治 疗，对吻与否？ 南京市第一医院 南京市心血管医院 南京市心脏病研究所 林松 陈绍良

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  1. 左主干末段分叉病变介入治 疗，对吻与否？ • 南京市第一医院 • 南京市心血管医院 • 南京市心脏病研究所 • 林松 陈绍良

  2. Randomized Comparison of Provisional Side Branch Stentingversus a Two-stent Strategy for treatment of True Coronary Bifurcation Lesions Involving a Large Side Branch. The Nordic-Baltic Bifurcation Study IV Indulis Kumsars, Matti Niemelä, Andrejs Erglis, Kari Kervinen, Evald H. Christiansen, Michael Maeng, Andis Dombrovskis, Vytautas Abraitis, Aleksandras Kibarskis, Terje K. Steigen, Thor Trovik, Gustavs Latkovskis, Dace Sondore, Inga Narbute, Christian Juhl Terkelsen, Markku Eskola, Hannu Romppanen, Per Thayssen, Anne Kaltoft,Tuija Vasankari, Pål Gunnes, Ole Frobert, Fredrik Calais, Juha Hartikainen, Svend Eggert Jensen, Thomas Engstrøm, Niels R. Holm, Jens F. Lassen and Leif Thuesen For the Nordic-Baltic PCI Study Group

  3. The Nordic-Baltic PCI Study Group Nordic-Baltic Bifurcation Study IV • Aim • To compare provisional stenting and two-stent techniques for the treatment of ”true” coronary bifurcation lesions involving a large side branch. • Hypothesis • Two stent techniques are superior to provisional stenting in treatment of ”true” coronary bifurcation lesions involving a large side branch

  4. Procedural data The Nordic-Baltic PCI Study Group Nordic-Baltic Bifurcation Study IV * (Residual stenosis <30% of MV + TIMI flow III in SB)

  5. Event-free survival at 6months Nordic-BalticBifurcationStudy IV 1.8% P=0.09 4.6% NTL MI = 1 TLR= 2 ST=1 vs. p=0.09 NTL MI = 1 TLR= 6 ST=2

  6. RCTs of Provisional vs. Elective Stenting“Higher-Risk” Bifurcations Chen SL, et al. J Am Coll Cardiol 2011;57:914–20.

  7. The Nordic-Baltic Bifurcation Study III • Conclusions: • In coronary bifurcation lesions, MV stenting with and without FKBD was associated with favorable and similar 6-month clinical outcomes. The simple no-FKBD procedure resulted in reduced use of contrast media and shorter procedure and fluoroscopy times. Angiographic SB outcome was improved by FKBD, especially in patients with true bifurcation lesions. In nontrue bifurcation lesions, no effect of FKBD was detected by either clinical or angiographic end points.

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