Evaluation Of Clinical Outcomes Of Single-stent Strategies In The Treatment Of Coronary Artery Bifurcation Lesions

Objective: To investigate the clinical outcomes of single-stent technique with different strategies applied in percutaneous coronary intervention in patients with coronary artery bifurcation lesions.Methods: Date of 441 patients with 442 bifurcation lesions were analyzed retrospectively. The patients who were diagnosed with coronary atherosclerotic heart disease and identified as true bifurcation lesions by coronary angiography were chosen from September 2013 to December 2015 in the Department of cardiovascular disease 1st Hospital of Jilin University. They all treated with PCI by single-stent technique. All the subject were categorized into three groups according to the operation of the side branch with different strategies: Group A contains 239 patients with 240 lesions given PCI by Jailed wire technique(JWT), Group B contains 128 patients with 128 lesions given PCI by bailout Jailed balloon technique(BJBT), Group C contains 74 patients with 74 lesions given PCI by active transfer of plaque(ATP). The basic clinical data, biochemical indicators, and information about coronary artery intervention operation of patients on admission were collected.Results: 1. Baseline data comparison: There was not statistical significance(P > 0.05) in blood pressure, diabetes, hyperlipidemia, and myocardial infarction history related diseases such as history, clinical diagnosis, the bifurcation les ion type, main and branch vascular stenosis degree, main and branch angle degree vessels such as comparative differences among all three groups.2. PCI general data comparison: JWT, BJBT and ATP main vessel stenting number among three groups, operation time, surgical success rate comparison differences had no statistical significance(P > 0.05); Balloon number among JWT,BJBT and ATP using comparative difference was statistically significant(P < 0.001), but there was not statistical significant difference between BJBT and ATP(P > 0.05).3. Intraoperative complications: the inc idence of JWT, BJBT and ATP among the three groups chest pain or TIMI flow less than or equal to 2 were statistical different between JWT and ATP(P = 0.003)、JWT and BJBT(P = 0.007);but there was no different between BJBT and ATP(P = 0.212);4. Branch opening degree of stenosis: PCI preoperative branch opening degree of stenosis in JWT, BJBT and ATP comparing differences among three groups had no statistical significance(P > 0.05); The immediate clinical effect after stenting branch opening degree of stenosis in JWT, BJBT and ATP comparing differences among three groups was statistically significant(P<0.001);5. During the period of hospitalization MACE events : There were no statistical significance in major adverse cardiovascular events during hospitalization among all three groups(P> 0.05).Conclusion:Patients with coronary bifurcation lesions treated with single-stent PCI:1. The immediate clinical effect of ATP in the treatment of coronary bifurcation lesions(the degree of stenosis after stent implantation, the incidence of chest pain and slow blood flow) is better than BJBT and JWT;2. Branch balloon protection technique can reduce the incidence of complications such as slow blood flow in coronary bifurcation lesions;3. Branch balloon protection technique is simple, safe and effective, can be used in coronary bifurcation lesions.