Fate Of Side Branches Covered By Coronary Stents

It has been reported that the bifurcation lesion treatment in all percutaneous coronary intervention accouted for up to 16%. This percentage can greatly increase with the emerging of drug eluting stents which will expand indications. But comparing with the non-bifurcation lesions, the bifurcation lesion treatment has the lower success rate, higher complication rate, higher restenosis rate and the poorer remote clinical outcomes.The most important problem in the bifurcation treatment is the problem of side branch. What kind of side branches should be protected? What are the risk factors of side branch occlusion? Some studies have been performed on these topics after bare metal stenting. But it was unclear whether the side branch occlusion rate would be higher for the polymer coated on the surface of the drug eluting stents. In this study, we assessed the angiograms and medical records of two hundred and thirty-six patients who had stent implantation and follow-up angiograms. Any side branches covered by the stents was evaluated. The results shows side branch occlusion occurred in 9.09% in cypher DES group , 10.50% in taxus DES group and 9.31% in BMS group. Spontaneous recanalization was observed in 76.47% in cypher DES, 63.16% in taxus stent group and 74.07% in BMS. The side branches with ostial stenosis before stenting and origining from the lesion of the parent vessel are at the risk of occlusion.Large side branch occlusion may result in significant clinical syndromes such as AMI. So the jailed large side branches usally be stented or treated with balloon. This study included 73 patients with side branches jailed by main branch stents. Three different methods used to treat these branches: (1) stenting at the ostium of the side branch; (2) angioplasty across the metallic structure; (3) no treatment. The stented group had the most favorable immediate angiographic results, but during follow up there was no significant difference among three...