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Double versus single stenting for coronary bifurcation lesions: a meta-analysis
Demosthenes G Katritsis1, George C M Siontis, John P A Ioannidis
1Department of Cardiology, Athens Euroclinic, Athens, Greece.
Circulation. Cardiovascular Interventions
|December 25, 2009
Summary
Double stenting for coronary bifurcation lesions increases risks of myocardial infarction and potentially stent thrombosis compared to single stenting. Further research is needed to confirm stent thrombosis findings.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Coronary artery disease management involves complex decisions regarding bifurcation lesions.
- The optimal stenting strategy for bifurcation lesions remains debated.
Purpose of the Study:
- To compare the safety and efficacy of double stenting versus single stenting in patients with coronary bifurcation lesions.
Main Methods:
- A meta-analysis of randomized controlled trials was performed.
- Included studies involved patients undergoing percutaneous coronary intervention for bifurcation lesions.
- Six trials with 1642 patients were analyzed.
Main Results:
- Double stenting significantly increased the risk of myocardial infarction (RR 1.78, P=0.001).
- A trend towards increased stent thrombosis with double stenting was observed, though not statistically significant (RR 1.85, P=0.19).
- No significant differences were found in mortality or target lesion revascularization rates.
Conclusions:
- Stenting both the main vessel and side branch in bifurcation lesions may elevate risks of myocardial infarction and stent thrombosis.
- Single stenting of the main vessel appears to be a safer strategy regarding myocardial infarction.
