Dedicated Bifurcation Stents vs. Regular Drug-Eluting Stents in Coronary Bifurcation Treatment: A Systematic Review and Meta-Analysis of 1-Year and 4-Year Outcomes, Including Left Main and Non-Left Main Subgroup Comparisons
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background: Dedicated bifurcation stents (DBS) were developed to overcome the limitations of conventional drug-eluting stents (DES) in percutaneous coronary intervention (PCI) for bifurcation lesions, but their clinical benefit remains uncertain. Methods: We conducted a systematic review and meta-analysis of randomized trials comparing DBS with contemporary DES in bifurcation PCI. Primary outcomes included all-cause death, myocardial infarction (MI), and target lesion revascularization (TLR) at 1 and 4 years. Subgroup analyses were performed for left main (LM) and non-LM bifurcations. Results: Ten trials involving approximately 2500 patients were analyzed. At 1 year, DBS and DES demonstrated similar rates of all-cause death (RR 1.12, 95% CI 0.81–1.55), MI (RR 0.80, 95% CI 0.38–1.69), and TLR (RR 1.23, 95% CI 0.79–1.90). At 4 years, results remained consistent: all-cause death (RR 1.10, 95% CI 0.75–1.60), MI (RR 0.66, 95% CI 0.29–1.49), and TLR (RR 1.29, 95% CI 0.86–1.94). No significant differences were observed between LM and non-LM subgroups, and no excess in late stent thrombosis was detected. Conclusions: DBS are safe and provide outcomes comparable to DES in bifurcation PCI. Their use may be reasonable in selected anatomies, but larger trials are needed to define their clinical advantage.
Source: Biomedicines
Authors: Jacek Bil, Adam Kern, Aneta I. Gziut-Rudkowska, Jarosław Zalewski, Krystian Bojko, Robert J. Gil
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W4416139477