Immediate and long-term clinical and angiographic results from Wiktor stent treatment for true bifurcation narrowings

Area of Science:

• Interventional Cardiology
• Cardiovascular Research
• Medical Device Technology

Background:

• True bifurcation lesions pose significant challenges in percutaneous coronary intervention (PCI).
• Optimal stent strategy for these complex lesions remains a subject of debate.
• Wiktor stent implantation was utilized in this comparative study.

Purpose of the Study:

• To compare the efficacy and safety of a simple PCI strategy versus a complex stenting technique for true bifurcation lesions.
• To evaluate restenosis rates and major adverse cardiac events (MACE) at 12 months.
• To determine the optimal approach for managing true coronary artery bifurcation lesions.

Main Methods:

• A prospective study involving 90 patients with true bifurcation lesions treated with Wiktor stents from January 1996 to December 1998.
• Group I (n=45): Simple approach (main vessel stenting, side branch balloon angioplasty).
• Group II (n=45): Complex approach ('T' stenting technique for both main and side branches).

Main Results:

• Both strategies achieved high procedural and angiographic success rates (100% and 95.6%, respectively).
• The simple approach (Group I) showed a significantly lower side branch restenosis rate (12.5% vs. 37.5% in Group II, p<0.05).
• No significant differences were observed in in-hospital or 12-month major cardiac events, though event-free probability favored the simple approach (80% vs. 61%).

Conclusions:

• A simple PCI strategy for true bifurcation lesions is associated with a lower risk of side branch restenosis.
• Complex stenting techniques ('T' stenting) do not appear to offer advantages in terms of early or long-term outcomes or overall restenosis rates.
• The findings suggest that a simplified approach may be preferable for managing true bifurcation lesions to reduce restenosis in the side branch.