Hosein Douste Kami , Adalat Hosseinian , Effat Mazaheri, Naser Aslanabadi , Samad Ghaffari , Bahram Sohrabi , Eiraj Mohammadzadeh , Farhad Pourfarzi , Naser Moaiiednia ,
Volume 13, Issue 3 (autumn 2013)
Background & Objectives: Coronary bifurcation lesions are important, complex lesions with different therapeutic strategies. In this study, patients with Coronary bifurcation lesions were treated and clinical results in these patients were followed during the nine-month period.
Methods: This descriptive analytical study was performed between January 2007 to December 2008 at Tabriz Shahid Madani Cardiovascular Center. We have studied 96 patients (83 male and 13 female). Patients on the basis of one or two stents were placed in one group and the other groups were divided based on the use of Drug Eluting Stent and Bare Metal Stent. After diagnostic angiography if coronary bifurcation lesions were present based on Medina classification, appropriate angioplasty treatment was carried out. In a situations including chest pain, electrocardiographic changes or the objective evidence of ischemia and indication of angiography, appropriate diagnostic tests during follow up period were done. Clinical outcomes including acute coronary events were recorded. And result analyzed using SPSS version 16 . Chi-square ، Fisher and T tests were used to compare the relationship between variables.
Results: In this study 86.5% was male and 13.5% female. The mean age of these patients was 56±9.9 years old. The most prevalent risk factor was HTN with 41.7% incidence and 55.2% of patient had chronic stable angina and 26% of them had history of acute myocardial infarction, 7.2% with history of PCI and 5.2% with history Of CABGS. Most prevalent site of bifurcation was ALD/diagonal with 65.5% incidence. The most prevalent complication was mild bleeding from puncture site with 10.4% and 5.2% of patients had mild hematoma. Among patients with two stents versus one stent presence of AMI presentation with CSA, ST Elevation in ECG was statistically significant. Also involvement of SB (side branch) lesions lengths at SB, kissing ballooning after implantation of two stents were statistically significant. Among patients with DES versus BMS usage of stent in RCA, LAD, lesion lengths at PMB (proximal main branch), DMP (distal main branch) and SB, procedure time, radiation dose, fluoroscopy time were statistically significant. Among two groups MACE (major acute coronary event) in two stents patient between 1-3 month and total MACE at first 6 month were statistically significant
Conclusion: The age of patients treated with CBL was low, also more usage of BMS and stenting of BFLs with two BMS had weak results in this study but surprisingly total results of BMS and DES did not have significant difference after 9 months follow up between two groups.