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Bioresorbable scaffolds may be feasible for bifurcation lesions
Bioresorbable scaffolds were associated with minimal target lesion revascularization and scaffold thrombosis in a cohort of patients with coronary bifurcation lesions in a recent study.
The researchers compared outcomes for provisional stenting and double stenting in 132 patients with coronary bifurcation lesions treated between 2012 and 2014. The primary endpoint was major adverse cardiac events at 1 year, including all-cause death, MI and target vessel revascularization.
Provisional stenting was used in 81% of procedures while 19% were double stenting. Ten of the lesions were treated with no crossover stenting and were not included in final analysis, according to the results.
True bifurcation lesions were reported in 52% of patients in the provisional stenting group and 91.3% of those in the double stenting group (P < .001). Crossover from provisional stenting to T-stenting occurred in 7.1% of patients in that group. Clinicians treated the side branch with bioresorbable scaffolds in 57% of patients in the double stenting group.
Forty-three percent of lesions were treated using a hybrid stenting technique, which the researchers defined as bioresorbable scaffold to the main branch and metallic drug-eluting stent to the side branch.
At 1 year, TLR occurred in 5.5% of patients in the provisional stenting arm and 11.2% of those in the double stenting arm (P = .49). The 1-year MACE rate was 10.5% overall, with rates of 9.5% in the provisional stenting group and 11.2% in the double stenting group (log rank P = .91).
There was no definite scaffold thrombosis observed in any bifurcation lesion.
Periprocedural MI occurred slightly more frequently in the double stenting group compared with the provisional stenting group, 18.2% vs. 11.2% (P = .38). No patients in the double stenting group experienced side branch occlusion.
“These findings suggest that [bioresorbable scaffold] implantation for bifurcation lesions is technically feasible,” the researchers concluded. – by Rob Volansky
Disclosure: One researcher reports being on the advisory board of Medtronic.