Asymmetrical expansion of the stent produces an uneven neointimal growth and increases the risk of thrombosis. The study was divided into two parts: the first one aimed at comparing, in the acute phase and the medium term, the result of provisional bifurcation stenting technique with sirolimus-eluting stent vs everolimus-eluting stent (both guided by IVUS); the second one aimed at investigating whether the asymmetric expansion can cause re-endothelialization issues.
The study included 229 patients with bifurcation lesions, of which 239 [SIC] received the everolimus-eluting stent (Xience V/Promus), and 60 received the sirolimus-eluting stent (Cypher Select). There were no significant differences in MACE (death, myocardial infarction, revascularization, or stent thrombosis) at 9 months between the two stents. Patients who underwent the kissing balloon technique had a higher rate of side branch dissection with the subsequent need for a second stent.
Conclusion: Both stents were similar for treating bifurcations with provisional stent technique guided by IVUS. The kissing balloon technique increases the chance of side branch dissection and stent asymmetric expansion if the main branch, but decreases side branch restenosis and increased luminal diameter of the main branch after 9 months without changing the MACE.
Yoshinobu Murasato.
2013-05-23
Original title: Mid-term results of Japanese registry study in comparison between everolimus-eluting stent and sirolimus-eluting stent for the bifurcation lesion (J- REVERSE).
