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Short- and long-term outcomes of compromised side branches after Multi-Link stent implantation
Shoichi Ehara1, Kenei Shimada, Yoshiki Kobayashi
1Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Japan. ehara@med.osaka-cu.ac.jp
Insights
Multi-Link stents show good long-term outcomes for side branches, even with immediate occlusion. Re-intervention is often successful, making these stents suitable for use near side branches.
Area of Science:
- Cardiovascular Interventions
- Medical Device Technology
Background:
- Multi-Link stents offer low restenosis and target vessel revascularization rates.
- Limited data exist on the long-term outcomes of side branches after stenting.
Purpose of the Study:
- To evaluate short- and long-term clinical outcomes after Multi-Link stent deployment.
- To identify angiographic predictors of side-branch occlusion.
Main Methods:
- Analysis of 137 Multi-Link stent deployments.
- Assessment of immediate and long-term side-branch patency and clinical events.
- Identification of angiographic predictors for side-branch occlusion.
Main Results:
- Immediate side-branch occlusion occurred in 25% of cases, with successful re-intervention in 85%.
- Intrinsic ostial disease (>50%) and mid-stented segment origin predicted occlusion.
- Long-term side-branch patency was well maintained.
- Restenosis and target vessel revascularization rates were 19% and 15%, respectively.
Conclusions:
- Multi-Link stents are recommended for use even when side branches are present near the stenosis.
- Successful re-intervention strategies can mitigate immediate side-branch occlusion.
- Long-term outcomes for side branches are favorable, supporting the safety and efficacy of Multi-Link stents.
Abstract:
The Multi-Link stent is superior to other stents in terms of low rates of restenosis and target vessel revascularization. However, few data exist regarding short- and long-term outcomes for side branches after stenting. We evaluated short and long clinical outcomes and angiographic predictors of side-branch occlusion after the deployment of 137 Multi-Link stents. Thirty-four (25%) of the 137 side branches occluded immediately after stenting. We attempted reangioplasty for the side branches and our success rate was 85%. The incidence of side branches with intrinsic ostial disease was more than 50% before stenting and origination from the stented midsegment was a powerful angiographic predictor of side-branch occlusion. Side-branch patency is well maintained long-term. The incidence of restenosis within and near the stented segment of the parent vessel was 19%, and the incidence of target vessel revascularization was 15%. We recommend the use of Multi-Link stents regardless of the presence of side branches in the vicinity of the stenosis.