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Long-Term Clinical Outcome of a Single Stent Approach With and Without a Final Kissing Balloon Technique for Coronary Bifurcation
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- Yamawaki Masahiro
- Division of Cardiology, Saiseikai Yokohama City Eastern Hosipital
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- Muramatsu Toshiya
- Division of Cardiology, Saiseikai Yokohama City Eastern Hosipital
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- Kozuma Ken
- Teikyo University Hospital
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- Ito Yoshiaki
- Division of Cardiology, Saiseikai Yokohama City Eastern Hosipital
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- Kawaguchi Ren
- Gunma Prefectural Cardiovascular Center
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- Kotani Jun-ichi
- National Cerebral and Cardiovascular Center
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- Yokoi Hiroyoshi
- Kokura Memorial Hospital
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- Nakamura Masato
- Toho University Ohashi Medical Center
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- Saito Shigeru
- Shonan Kamakura General Hospital
Bibliographic Information
- Other Title
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- Long-Term Clinical Outcome of a Single Stent Approach With and Without a Final Kissing Balloon Technique for Coronary Bifurcation : Subanalysis of the TAXUS Japan Postmarket Surveillance Study
- – Subanalysis of the TAXUS Japan Postmarket Surveillance Study –
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Description
Background: The advantages of the final kissing balloon technique (FKB) in a provisional 1-stent approach are under debate. Long-term clinical outcomes remain unclear due to limited data. Methods and Results: Of 2,132 patients (2,502 lesions) enrolled in the TAXUS Japan Postmarket Surveillance Study at 56 centers between July 2007 and December 2008, patients having coronary bifurcation treated with a single cross-over stenting with FKB (FKB-group: 132 patients/137 lesions) were compared to those treated without FKB (no-FKB-group: 121 patients/124 lesions). The no-FKB-group was also compared with non-bifurcation patients who had a single-stent implantation (814 patients/937 lesions). The primary outcome was MACE (major adverse clinical events), defined as cardiac death, myocardial infarction and target vessel revascularization (TVR) at 3 years. Higher late loss and binary restenosis were found in the main vessel (MV) of the FKB-group at the 9-month angiogram compared to the no-FKB-group. At 3 years, MACE was numerically higher (14.6% vs. 6.9%, P=0.07) and TVR was significantly higher (14.6% vs. 5.9%, P<0.05) in the FKB-group compared with the no-FKB-group. The rate of MACE (6.9% vs. 10.4%, P=0.34) and TVR (5.9% vs. 7.7%, P=0.57) were similar between the no-FKB and non-bifurcation patients. Conclusions: In a 1-stent approach, FKB was associated with worse angiographic outcomes in the MV, and did not demonstrate any clinical benefit over the long-term follow-up period. Cross-over stenting without FKB showed similar clinical outcomes to patients without bifurcation. (Circ J 2014; 78: 110–121)<br>
Journal
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- Circulation Journal
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Circulation Journal 78 (1), 110-121, 2014
The Japanese Circulation Society
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