Effect of Clinical and Lesional Characteristics On Side Branch Compromise During Provisional Bifurcation Stenting

Abstract

Background :
One of the most serious side effects of percutaneous coronary intervention (PCI) for bifurcation
lesions is major side branch (SB) blockage. PCI is used to treat coronary bifurcations lesions in
about 15-20% of cases. Because of the risk of SB compromise, PCI of coronary bifurcation
lesions is frequently thought to be a difficult procedure.
OBJECTIVE: The goal of this study was to investigate the clinical and lesional predictability of
severe SB blockage during coronary bifurcation intervention.
MATERIAL & METHODS: It was a retrospective study performed at Cardiac Catheterization
Lab, Punjab Institute of Cardiology, Lahore. It was a six months study from 15th April 2022 to
14th Oct, 2022. 93 patients enrolled using non-probability sampling technique. Patients between
the ages of 30 and 70 of either gender, with coronary bifurcation lesions undergoing PCI and at
least one significant SB were included. Data was entered in the predesigned proforma. SPSS
version 24 was used to analyze our data.
RESULTS: In our study a total of 93 patients were enrolled, the mean age of the cases was
53.30 ± 1.12. There were 68 (73%) male and 25 (27%) females in our study. There were 52
(56%) diabetic, 50 (54%) hypertensive, 63 (68%) smokers and 42 (45%) hypercholestrolemic
patients were present in our study. In our study 36 (39%) patients were found with family history
of CAD and 6 (7%) patients found with recent MI. LAD was most frequently utilized bifurcation
lesion in our study. The mean of lesion length was 28.82 ± 10.91 in this study. SB angle was 41º-
50º in most of the cases 20 (22%), side branch diameter stenosis post MV stenting was 70-75%
in 40 (43%) cases. Medina classification 1,1,1 was found in 43 (46%) cases. In 62 (67%) cases
no side branch jailing was observed. Side branch predilatation before MV stenting was found in
72 (77%) cases. Need of stenting in SB was found in 60 (65%) cases. Most frequently used
technique for SB provisional stenting was DK crush and mini crush in this study.
Keywords: Bifurcation Lesions, SB, PCI