Long-term outcomes after ostial stenting for 0.0.1 and 0.1.0 coronary bifurcation lesions. Results from the real-world multicenter registry
Year: 2026
Type: article
Study design: Observational Study
Abstract: While crossover stenting (CS) remains the gold standard for treating most bifurcation lesions, ostial stenting (OS) may be considered for patients with favorable anatomy. The aim of this study was to evaluate outcomes following OS versus CS in patients with 0.1.0 and 0.0.1 bifurcation lesions. 790 patients, who underwent PCI for 0.1.0 and 0.0.1 lesions and had clinical follow up were included in the analysis. The patients were divided into OS group (n=186) and CS group (n=604). Inverse probability treatment weighting model was used to assess long-term outcomes. OS more often performed in patients with left main disease (52% vs. 31%, p < 0.001) Patients in the OS group more often had calcification (23% vs. 15%, p=0.026) and thrombosis (11% vs. 6.5%, p=0.044). The occurrence of residual dissection was significantly lower in the OS group (0.2% vs. 3.1%, p=0.007 ) as well as disturbance of blood flow in the SB after stent implantation (0.5% vs. 3.2% p=0.007). The median follow-up was 1504 days. There were no significant differences in the MACE between groups (18.9% vs. 22.2%, p=0.331). However, a lower rate of target vessel revascularization (TVR) was observed in OS group (2.4% vs. 0.5%, p=0.046). In patients with 0.0.1 and 0.1.0 coronary bifurcations, OS associated with less residual stenosis and lower incidence of blood flow disturbance in the SB after stent implantation and a lower incidence of TVR at follow-up, compared to the CS , but this was not accompanied by a reduction in the rates of MACE. Stenting strategy of 0.1.0 and 0.0.1 bifurcation lesions remains an unresolved issue. While crossover stenting remains the gold standard for treating most bifurcation lesions, ostial stenting may be considered for patients with favorable anatomy. In the multicenter all-comer registry patients treated with ostial stenting had a lower incidence of target vessel revascularization compared with patients treated with crossover technique and comparable MACE rates. Ostial stenting associated with better procedural results with less dissections in both the MB and the SB, less residual stenosis and blood flow disturbance in the SB after stent implantation.
Source: Hellenic Journal of Cardiology
Authors: Dmitrii Khelimskii, Ivan Bessonov, Maksim Kashtanov, Stanislav Sapozhnikov, Ruslan Utegenov, Serezha Manukian, Aram Badoian, Aleksey Baranov, Oleg Krestyaninov
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7130351525