Impact of bifurcation stent technique on clinical outcomes in patients with a Medina 0,0,1 coronary bifurcation lesion: Results from the cobis (coronary bifurcation stenting) II registry

Conclusions: In patients with a Medina 0,0,1 type bifurcation lesion, the 2-stent technique seems to be associated with a better clinical outcome compared with the 1-stent technique. These findings need to be confirmed in randomized controlled trials.

Objective: To compare the long-term clinical outcomes of patients treated with 1-versus 2-stent techniques for Medina 0,0,1 type bifurcation lesions.

Background: Little is known about clinical outcomes and optimal treatment strategies for Medina 0,0,1 type bifurcation lesions.

Methods: A total of 2,897 consecutive patients who underwent percutaneous coronary intervention using a drug-eluting stent for a coronary bifurcation lesion with a side branch (SB) ≥2.3 mm were enrolled from 18 centers in South Korea. We compared target lesion failure (TLF), defined as the composite of cardiac death, myocardial infarction, or target lesion revascularization (TLR) according to 1- or 2-stent techniques in the patients with a de novo Medina 0,0,1 type bifurcation lesion (n = 113, 3.9%).

Results: Fifty patients were treated with the 1-stent technique, and 63 patients with the 2-stent technique. During a median follow-up duration of 36.6 months, patients in the 1-stent technique group tended to have a higher incidence of TLR (3.2 versus 12.0%, P = 0.07) and TLF (4.8 versus 12.0%, P = 0.16) than those in the 2-stent technique group. Multivariate analysis revealed that the 1-stent technique was associated with a higher risk of TLR (hazard ratio [HR] 7.35; 95% confidence interval [CI] 1.27-42.5; P = 0.03) and TLF (HR 4.65; 95% CI1.01-21.6; P = 0.05) than the 2-stent technique.