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Cardiologia Croatica, Vol. 15 No. 3-4, 2020.

Meeting abstract

https://doi.org/10.15836/ccar2020.51

Treatment of a true CXA-OM bifurcation lesion using a one stent drug coated balloons provisional technique

Krešimir Gabaldo orcid id orcid.org/0000-0002-0116-5929 ; General Hospital „Dr. Josip Benčević“ Slavonski Brod, Slavonski Brod, Croatia
Božo Vujeva ; General Hospital „Dr. Josip Benčević“ Slavonski Brod, Slavonski Brod, Croatia
Katica Cvitkušić Lukenda ; General Hospital „Dr. Josip Benčević“ Slavonski Brod, Slavonski Brod, Croatia
Marijana Knežević Praveček ; General Hospital „Dr. Josip Benčević“ Slavonski Brod, Slavonski Brod, Croatia
Domagoj Vučić ; General Hospital „Dr. Josip Benčević“ Slavonski Brod, Slavonski Brod, Croatia

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Abstract

Background: Provisional stenting is a favorable option for most bifurcation lesions, while two stent techniques show benefits in true bifurcation performed by experts. Using one stent and DCB in true bifurcation lesions still remains questionable.1,2
Case report: 76-year-old male presented with persisting chest pain. ECG showed no specific ischemic changes, while hsTnI was highly elevated. He had gone PCI LAD 14 years ago. Diagnosis: right coronary angiography revealed occlusion of RCA, while left coronary angiography revealed LLS of 20% in proximal LAD stent, 70% stenosis of mid LAD, and acute occlusion of secondary OM branch on bifurcation level, while CxA was stenosed 70-80%. Management: PCI CxA-OM2 was performed with DES Xience expedition 2,75/33mm in CxA-OM2 with POT 3,25/12mm proximally, then after rewiring and adequate lesion preparation a DEB Sequent please 2,5/25mm in CxA distally was performed. After two months we performed an elective PCI LAD and checked out the result of CxA bifurcation which was optimal.
Conclusion: Using one stent and DCB in true bifurcation lesions still remains questionable. There are no data from a prospective study, while there are data from the observational study which enrolled 130 patients. DCB-only strategy was performed in 54% patients, 34.6% had at least one stent in the main branch, 8.5% had at least one stent in the side branch and 3.1% at least one stent in the main branch and side branch. Study follow up lasted for 9.8 months. The TLR rate was 4.5%, MACE was 6.1%, and no stent thrombosis was detected. This study suggested that the DCB+one stent, and DCB-only strategy was safe and effective in selected bifurcations, possibly allowing for an abbreviated antiplatelet regimen.

Keywords

bifurcation lesions; acute coronary syndrome; drug coated balloons

Hrčak ID:

236205

URI

https://hrcak.srce.hr/236205

Publication date:

26.3.2020.

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