Related Experiment Video

Updated: Sep 22, 2025

Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit
06:11

Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit

Published on: May 14, 2020

2.5K

Predicted and Observed Mortality at 10 Years in Patients With Bifurcation Lesions in the SYNTAX Trial

Kai Ninomiya1, Patrick W Serruys2, Scot Garg3

  • 1Department of Cardiology, National University of Ireland, Galway, Galway, Ireland.

JACC. Cardiovascular Interventions
|May 20, 2022
PubMed

Insights

Percutaneous coronary intervention (PCI) for bifurcation lesions is linked to higher 10-year mortality compared to coronary artery bypass grafting (CABG). The SYNTAX score 2020 aids in choosing the best treatment for these complex cases.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Percutaneous coronary intervention (PCI) for bifurcation lesions carries higher adverse event rates.
  • The optimal treatment strategy (PCI vs. coronary artery bypass grafting [CABG]) for bifurcation lesions remains unclear for very long-term outcomes.

Purpose of the Study:

  • To assess the impact of bifurcation lesions on predicted and observed 10-year all-cause mortality.
  • To compare PCI and CABG in patients with and without bifurcation lesions using the SYNTAX score 2020.

Main Methods:

  • Analysis of the SYNTAX Extended Survival (SYNTAXES) study data.
  • Comparison of 10-year mortality between patients with (n=1,300) and without (n=487) bifurcation lesions.
  • Utilized the SYNTAX score 2020 (SS-2020) for individual mortality prediction.

Main Results:

  • PCI patients with >1 bifurcation lesion had higher all-cause death risk (30.1%) vs. no bifurcations (19.8%).
  • CABG showed similar mortality for patients with (23.3%) and without (23.0%) bifurcation lesions.
  • A 2-stent PCI technique was associated with increased mortality compared to a 1-stent technique.

Conclusions:

  • Bifurcation lesions necessitate careful heart team consideration due to higher PCI-related 10-year mortality.
  • Individualized prognosis using SS-2020 can guide treatment decisions for bifurcation lesions.
  • SYNTAXES study provides crucial long-term data on PCI vs. CABG for bifurcation lesions.
Abstract

Keywords:
CABGPCISYNTAXbifurcation lesionlong-term clinical outcomes

More Related Videos

Monitoring Neuronal Survival via Longitudinal Fluorescence Microscopy07:02

Monitoring Neuronal Survival via Longitudinal Fluorescence Microscopy

Published on: January 19, 2019

6.6K
Vessel-sparing Excision and Primary Anastomosis08:09

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

11.6K

Related Concept Videos

Truncation in Survival Analysis01:09

Truncation in Survival Analysis

Truncation in survival analysis refers to the exclusion of individuals or events from the dataset based on specific criteria related to the time of the event. This exclusion can happen in two primary forms: left truncation and right truncation.
Left truncation occurs when individuals who experienced the event of interest before a certain time are not included in the study. This is often due to a "delayed entry" into the study where only those who survive until a certain entry point are...
328
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
36
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
27
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
39
Actuarial Approach01:20

Actuarial Approach

The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
140