Original Article
Effectiveness and safety of the side-branch balloon pre-imbedding technique on coronary bifurcation lesions in elderly patients
Qiao Yong, Yan Gaoliang, Wang Dong, Wang Jing, Kong Wenjie, Ma Genshan, Tang Chengchun
Published 2016-02-14
Cite as Chin J Geriatr, 2016, 35(2): 151-155. DOI: 10.3760/cma.j.issn.0254-9026.2016.02.010
Abstract
ObjectiveTo study the effectiveness and safety of the side-branch (SB) balloon pre-imbedding technique on coronary bifurcation lesions (CBLs) in elderly patients.
MethodsA retrospective analysis was conducted on 111 elderly patients with CBLs in our hospital from January 2011 to January 2013, of whom 59 patients received SB balloon pre-imbedding and 52 patients received SB wire protection. The immediate blood flow of the side-branch after treatment, the performance of the stent, and major adverse cardiovascular events (MACE) during hospitalization, 6 and 12 months after treatment, and coronary angiography 6 months after treatment were compared between the two groups.
ResultsThere were no statistical differences between the two groups in clinical characteristics, lesion distribution, length and diameter of MB or SB, bifurcation angle, length and number of main branch(MB) stenting, or MACE during hospitalization and 6 months after treatment (each P>0.05). There was no statistical difference in immediate postoperative angiography between patients with thrombolysis in myocardial infarction (TIMI) grade 3, coronary stenosis more than 25% in the MB (P>0.05). The percentages of patients with coronary stenosis more than 50 % in SB and patients who needed SB stenting were lower in the balloon pre-imbedding group than in the wire protection group〔8.5% (5/59)vs. 23.1% (12/52), 42.4% (25/59) vs. 61.5% (32/52), each P<0.05〕. After 6 months of treatment, there was no statistical difference in coronary angiography in TIMI grade 3 of MB and coronary stenosis more than 25% in MB between the two groups (P>0.05). Also, the percentage of patients with TIMI grade 3 in SB was higher in the balloon pre-imbedding group than in the wire protection group (37/41vs. 24/34, P<0.05); the percentage of patients with coronary stenosis more than 50% in SB was lower in the balloon pre-imbedding group than in the wire protection group (3/41vs. 8/34, P<0.05); and the degree of stenosis, the late lumen loss and the incidence of stent restenosis in SB were lower in the balloon pre-imbedding group than in the wire protection group (P<0.01). The incidence of MACE 12 months after PCI was lower in the balloon pre-imbedding group than in the wire protection group (7/59vs. 14/52, P<0.05). The pre-balloon imbedding group had a lower cost than the wire protection group, but with no statistical significance〔(55 113±968) RMBvs. (61 023±1 311) RMB, P>0.05〕.
ConclusionsSB balloon pre-imbedding is safe for the treatment of CBLs in elderly patients, and its effectiveness in both short- and long-term is better than that of wire protection.
Key words:
Coronary artery disease; Stents; Prognosis
Contributor Information
Qiao Yong
Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
Yan Gaoliang
Wang Dong
Wang Jing
Kong Wenjie
Ma Genshan
Tang Chengchun