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Published in: BMC Cardiovascular Disorders 1/2019

Open Access 01-12-2019 | Myocardial Infarction | Research article

Clinical outcomes of coronary artery bifurcation disease patients underwent Culotte two-stent technique: a single center experience

Authors: Chih-Feng Chang, Keng-Hao Chang, Chih-Hung Lai, Tzu-Hsiang Lin, Tsun-Jui Liu, Wen-Lieng Lee, Chieh-Shou Su

Published in: BMC Cardiovascular Disorders | Issue 1/2019

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Abstract

Background

Percutaneous coronary intervention for coronary artery bifurcation disease (CABD) remains challenging. In patients of CABD with situations that two-stent strategy is needed, the culotte technique is a widely used method and also as the majority at out institution. We sought to take a look of the clinical outcomes of our culotte stenting patients.

Methods

This retrospective study analyzed 238 consecutive CABD patients who underwent culotte two-stent technique at a tertiary medical center between July 2008 and November 2015.

Results

Culotte technique was used in 238 lesions in 238 patients. Of these patients, all DES were implanted for culotte two-stent technique. Most of these patients were elderly, male gender, ACS on admission and multiple vessel disease. The bifurcation lesions were mostly located at left coronary artery (51.3%), categorized as true bifurcation lesion (92%) and calculated less than 70 degree of bifurcation angle (74.4%). During a medium 3.27-year follow up, the angle of bifurcation lesion ≥70° and body mass index were positively independent predictors for target lesion failure (TLF), diabetes mellitus was an independent predictor of target vessel revascularization, and statin therapy for hyperlipidemia, hemoglobin and EF were negatively independent factors associated to total mortality. The rates of in-hospital and total mortalities were 4.2 and 17.6%.

Conclusion

In this cohort of CABD patients with most left main and left anterior descending artery lesions treated by culotte stenting, the procedural success rate was high and the intermediate clinical outcomes were acceptable. (Reviewer #1, Comment #1) Bifurcation angle (≥ 70°) is an inherently independent predictor of TLF and other two-stent strategy replaced needed to be considered in this situation.
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Metadata
Title
Clinical outcomes of coronary artery bifurcation disease patients underwent Culotte two-stent technique: a single center experience
Authors
Chih-Feng Chang
Keng-Hao Chang
Chih-Hung Lai
Tzu-Hsiang Lin
Tsun-Jui Liu
Wen-Lieng Lee
Chieh-Shou Su
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2019
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-019-1192-2

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