Related Experiment Video

Updated: Jul 19, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.1K

"Main Vessel-Oriented" Treatment Strategy Versus "Open Side Branch" Treatment Strategy in Acute Coronary Syndrome

Kursat Tigen1, Zekeriya Dogan1, Murat Sunbul1

  • 1Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey.

The American Journal of Cardiology
|August 13, 2023
PubMed

Insights

For acute coronary syndrome (ACS) patients with bifurcation lesions, the open side branch (OSB) strategy improved procedural success, especially for larger side branches. Main vessel-oriented (MVO) strategies are suitable for minor side branches.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Coronary Syndromes

Background:

  • Percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients with bifurcation lesions carries a higher risk of complications.
  • Treatment strategies for these complex lesions require careful consideration to optimize outcomes.

Purpose of the Study:

  • To compare in-hospital outcomes of "main vessel-oriented" (MVO) versus "open side branch" (OSB) treatment strategies in ACS patients with culprit bifurcation lesions.
  • To identify specific lesion characteristics that may favor one strategy over the other.

Main Methods:

  • Retrospective analysis of 575 consecutive ACS patients undergoing PCI for bifurcation lesions.
  • Patients were categorized into MVO (ignoring side branch) or OSB (maintaining side branch patency) groups.
  • Procedural success and major adverse cardiac/cerebrovascular events were assessed.

Main Results:

  • The OSB strategy demonstrated a significantly higher procedural success rate compared to MVO.
  • Major adverse cardiac/cerebrovascular events were similar between groups, with slightly higher contrast-induced nephropathy in the OSB group.
  • Subgroup analysis showed superior procedural success with OSB for side branches ≥2mm located within the bifurcation core.

Conclusions:

  • The OSB strategy may offer better procedural outcomes in ACS patients with bifurcation lesions, particularly when the side branch is significant (≥2mm) and originates from the bifurcation core.
  • The MVO strategy may be a reasonable alternative for minor side branches distant from the bifurcation core, given similar procedural success rates.

Keywords:
acute coronary syndromesculprit bifurcation lesionmain vessel-oriented treatment strategyside branch opening

More Related Videos

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia07:46

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia

Published on: May 9, 2013

29.2K
Novel and Innovative Hybrid Technique for Type A Aortic Dissection06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

386

Related Concept Videos

Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
9
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
30
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
10
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
11
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
12
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...
10