One- Versus Two-Stent Stenting Strategies in Coronary Bifurcation Lesions


Chan Z., Alexandrou M., Strepkos D., Mutlu D., Carvalho P. E. P., Krestyaninov O., ...Daha Fazla

JOURNAL OF INVASIVE CARDIOLOGY, cilt.38, sa.1, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 38 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.25270/jic/25.00096
  • Dergi Adı: JOURNAL OF INVASIVE CARDIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Bezmiâlem Vakıf Üniversitesi Adresli: Evet

Özet

Objectives. Additional studies are needed on the follow-up outcomes of 1-vs 2-stent techniques in bifurcation percutaneous coronary interventions (PCI). Methods. The authors examined the angiographic and procedural characteristics, and outcomes of 1306 bifurcation PCIs (1139 patients) performed at 6 centers between 2014 and 2024 from the PROGRESS-BIFURCATION registry. Results. Upfront 1-stent PCI (96.2% provisional stenting, 2% mini crush with 1 stent, 1.7% side branch [SB] stent only) was used in 75.5% of lesions; upfront 2-stent PCI was used in 24.5% (48.1% double kissing crush, 16.9% culotte, 35% other). Patients treated with an upfront 2-stent strategy were older (68 +/- 12 vs 66 +/- 12 years; P = .011) and more likely to have dyslipidemia (82.7% vs 76.0%; P = .019) and a history of heart failure (27.6% vs 20.3%; P = .011). An upfront 2-stent strategy was more common in left main bifurcations and lesions with moderate/severe calcification or larger SB diameter. Upfront 2-stent strategies required longer procedure and fluoroscopy times and higher patient radiation dose but similar contrast volume. Two-stent strategies were associated with higher technical success (98.4% vs 94.4%; P = .003), but similar procedural success (93.5% vs 90.4%; P = .116) and in-hospital major adverse cardiac events (MACE) (5.2% vs 3.9%; P = .355) compared with 1-stent strategies. Follow-up data was available for 783 patients. During a median follow-up of 1095 days, patients treated with an upfront 2-stent strategy had similar incidence of MACE, target vessel revascularization, myocardial infarction, and all-cause mortality (adjusted hazard ratio for mortality, 0.99; 95% CI, 0.61-1.62; P = .98). Conclusions. Upfront 1-vs 2-stent bifurcation PCI was associated with similar procedural success and follow-up outcomes during a median follow-up of 3 years.