Drug‐eluting stents in bifurcation lesions: To stent one branch or both?

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Abstract
Objectives: The objective of this study was to compare two techniques to treat bifurcation lesions: a single drug‐eluting stent (DES) implanted in the main branch combined with balloon dilatation for the side branch vs. stenting of both branches (double stent). Background: Percutaneous coronary intervention in coronary bifurcation lesions remains challenging. Although DES reduce restenosis in lesions, the double stent procedure has not shown clear advantages over a single stent with balloon dilation. Methods: Fifty‐three symptomatic patients with true bifurcation lesions were treated using either the double stent technique (n = 25) or one stent in the parent vessel plus balloon angioplasty of the side branch (n = 28). Procedural results and major adverse cardiac event rates (MACE: cardiac death, myocardial infarction, target vessel revascularization (TVR)) were compared. Results: Angiographic procedural success (residual stenosis 50% diameter stenosis) in the ostium of the side branch was seen in two patients in the double‐stent group. At 6 months, MACE‐free was comparable between groups (89.3% vs. 88%, P = 0.7). Conclusions: When treating bifurcation lesions with sirolimus‐eluting stents, restenosis following a single stent procedure is comparable to stenting both parent and side branch vessels. Thus, stenting the main‐branch lesion, coupled with balloon angioplasty in the side branch, produces a high success rate and good clinical outcomes at 6 months.

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