Feature | November 01, 2013

Two Stents For Coronary Bifurcations Show Little Difference in Coronary Lesions

bifurcation stenting
November 1, 2013 — A new clinical trial showed that a two-stent technique for treatment of bifurcation lesions with a large stenotic side branch was not associated with significant improved outcomes compared to a provisional stenting approach. The findings from the Nordic-Baltic Bifurcation IV study were presented at the 25th annual Transcatheter Cardiovascular Therapeutics scientific symposium (TCT 2013). 
The Nordic-Baltic IV trial was a randomized, controlled, non-blinded, multicenter, superiority trial that compared provisional stenting with a two-stent strategy for the treatment of coronary bifurcation lesions involving a major side branch. 
The primary endpoint was the composite of major adverse cardiac events (MACE) including cardiac death, non-procedure-related myocardial infarction, target vessel revascularization and stent thrombosis after six months. Follow up is planned until five years. A total of 450 patients with coronary bifurcation lesions were randomized one-to-one to the provisional strategy (stenting of the main vessel and provisional stenting of the side branch) or a complex two-stent strategy (planned stenting of both the main vessel and the side branch).  
After six months, the MACE rate was not significantly different between provisional and two-stent techniques (4.6 percent and 1.8 percent, respectively) (p = 0.09). Individual endpoints were also similar between the two techniques including total death (0 and 0.4 percent (p = 0.32), non-procedural myocardial infarction (1.8 percent and 0.9 percent) (p = 0.50) and target vessel revascularization (3.7 percent and 1.3 percent) (p = 0.11). There were no incidents of cardiac death in either group.
However, in contrast to prior studies, longer and more complex procedures in the two-stent group did not translate into more procedural myocardial infarctions. 
“Results of this trial indicate that a two-stent technique does not significantly improve mid-term outcomes for patients with bifurcation lesions compared to provisional stenting,” said Indulis Kumsars, M.D., head of the cardiac catheterization laboratory, Latvian Cardiology Center in Riga, Latvia, and lead investigator of the study. 
Given the fact that there was a weak trend towards lower MACE in the two stent strategy and follow-up is continuing for five years, the Nordic-Baltic investigators concluded, “Recommendations on optimal strategies for this lesion subset should await longer term follow up.”
For more information: www.crf.org

Related Content

Shimadzu, MIX package, Trinias Cardiovascular suites, U.S. availability

Image courtesy of Shimadzu Medical Systems

Technology | Cath Lab| October 08, 2015
Shimadzu Medical Systems USA announced the availability of the MIX package for the Trinias Cardiovascular suites. Based...
ORSIF, radiation exposure for interventionalists, greater on left side of head, Ehtisham Mahmud
Feature | Radiation Dose Management| October 06, 2015
The results of a research study indicate that interventional cardiologists receive “very high” radiation exposure...
Synergy stent
Technology | October 05, 2015
October 5, 2015 — The U.S.
News | Heart Failure| October 02, 2015
Cyberonics Inc. announced results from the extension of the ANTHEM-HF clinical study (ENCORE Study). Results of the...
Tryton Side Branch Stent, clinical trial results, Catheterization and Cardiovascular Interventions

Tryton Side Branch Stent image courtesy of Tryton Medical

News | Stents Bifurcation| October 02, 2015
October 2, 2015 — Tryton Medical Inc.
Brilinta, 60 mg dose available, U.S. pharmacies
Technology | Antiplatelet and Anticoagulation Therapies| October 02, 2015
AstraZeneca announced that Brilinta (ticagrelor) 60-mg tablets are now available in U.S. pharmacies. On Sept. 3, 2015,...
Intact Vascular, TOBA II study, Tack Endovascular System

Image courtesy of Intact Vascular

News | Peripheral Arterial Disease (PAD)| October 01, 2015
Intact Vascular Inc. announced the U.S. Food and Drug Administration has granted conditional approval for a U.S. and...
Cook Medical, Zilver PTX, Japan PMS study, CIRSE 2015, two-year results

Image courtesy of Cook Medical

News | Stents Peripheral| October 01, 2015
Kimihiko Kichikawa, M.D., department of radiology at Nara Medical University in Japan, reported two-year results of the...
Stentys, CE Mark for self-apposing stent, lower limb artery disease, below-the-knee arteries, critical limb ischemia, PES BTK-70 trial

Image courtesy of Stentys

News | Stents Peripheral| October 01, 2015
Stentys announced that the company’s drug-eluting stent received CE Mark for treatment of below-the-knee (BTK) arteries...
raysafe, i2, staff dose monitoring
News | Radiation Dose Management| October 01, 2015
October 1,2015 — The first and only system that delivers real-time X-ray radiation dose monitoring for physicians and
Overlay Init