Reasons and frequency of transition to a double-stent technique when correcting bifurcation lesions of the coronary arteries in patients with acute coronary syndrome

The objective was to estimate the risk and predictors of intraoperative transition from a single-stent technique of correction of bifurcation lesions of the coronary arteries to a double-stent technique.METHODS AND MATHERIALS. The study included 49 patients (35 men – 71.4 % and 14 women – 28.6 %) wi...

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Main Authors: R. E. Kalinin, I. A. Suchkov, A. V. Karpov, I. B. Ilyasov, I. N. Shanaev
Format: Article
Language:Russian
Published: Pavlov First Saint Petersburg State Medical University 2023-12-01
Series:Вестник хирургии имени И.И. Грекова
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Online Access:https://www.vestnik-grekova.ru/jour/article/view/2235
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author R. E. Kalinin
I. A. Suchkov
A. V. Karpov
I. B. Ilyasov
I. N. Shanaev
author_facet R. E. Kalinin
I. A. Suchkov
A. V. Karpov
I. B. Ilyasov
I. N. Shanaev
author_sort R. E. Kalinin
collection DOAJ
description The objective was to estimate the risk and predictors of intraoperative transition from a single-stent technique of correction of bifurcation lesions of the coronary arteries to a double-stent technique.METHODS AND MATHERIALS. The study included 49 patients (35 men – 71.4 % and 14 women – 28.6 %) with acute coronary syndrome, whose coronary angiography revealed non-stem bifurcation lesions of the coronary arteries. The patients were operated with single- (Provisional) and double- (Culotte and TAR) stent techniques. Three patients had two bifurcation lesions at once. Thus, 52 bifurcations were included in the study. The average age of patients was 62±8 years. The lateral branch was affected in 34.6 % of cases. A blood clot in the bifurcation area was visualized in 15.4 % of cases. The study is a prospective analytical one. Statistical data processing was carried out using the chi-square test. The statistically significant value was considered p<0.05.RESULTS. In Y-type bifurcation, kissing dilation was performed in 50% of cases, and stent implantation into the lateral branch - in 23.8% of cases (47.6% of cases where kissing dilation was performed). In T-type bifurcation, kissing dilation was required in 33.3% of cases, and the transition to double-stent technique was required in 11.1% of cases (33.3% of cases where kissing dilation was performed (p=0.610)). With the initially affected lateral branch, kissing dilation was required in 88.2 % of cases, and stenting of the lateral branch was required in 47.1 % of cases (53.3% of cases where kissing dilation was performed). With an intact lateral branch, kissing dilation was required in 26.5 % of cases, the second stent was needed in 8.8 % of cases (33.3% of cases where kissing dilation was performed (p<0.001)). In the presence of a blood clot in the bifurcation area, the need for kissing dilation appeared in 75% of cases, and the need for double-stent technique – in 12.5% of cases (20% of cases where kissing dilation was performed).CONCLUSIONS. When using the Provisional techniques, the kissing dilation was required in 47.1 % of cases. Expansion of the scope of surgical intervention to double-stent technique was required in 21.6 % of cases.
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series Вестник хирургии имени И.И. Грекова
spelling doaj-art-6217a840fa134d2cb600c3f07d8bfb5a2025-08-20T04:00:33ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252023-12-011822293710.24884/0042-4625-2023-182-2-29-371493Reasons and frequency of transition to a double-stent technique when correcting bifurcation lesions of the coronary arteries in patients with acute coronary syndromeR. E. Kalinin0I. A. Suchkov1A. V. Karpov2I. B. Ilyasov3I. N. Shanaev4Ryazan State Medical University named after academician I. P. PavlovRyazan State Medical University named after academician I. P. PavlovRyazan State Medical University named after academician I. P. Pavlov; City hospital № 6 named after G. A. ZakharinCity hospital № 6 named after G. A. ZakharinRyazan State Medical University named after academician I. P. PavlovThe objective was to estimate the risk and predictors of intraoperative transition from a single-stent technique of correction of bifurcation lesions of the coronary arteries to a double-stent technique.METHODS AND MATHERIALS. The study included 49 patients (35 men – 71.4 % and 14 women – 28.6 %) with acute coronary syndrome, whose coronary angiography revealed non-stem bifurcation lesions of the coronary arteries. The patients were operated with single- (Provisional) and double- (Culotte and TAR) stent techniques. Three patients had two bifurcation lesions at once. Thus, 52 bifurcations were included in the study. The average age of patients was 62±8 years. The lateral branch was affected in 34.6 % of cases. A blood clot in the bifurcation area was visualized in 15.4 % of cases. The study is a prospective analytical one. Statistical data processing was carried out using the chi-square test. The statistically significant value was considered p<0.05.RESULTS. In Y-type bifurcation, kissing dilation was performed in 50% of cases, and stent implantation into the lateral branch - in 23.8% of cases (47.6% of cases where kissing dilation was performed). In T-type bifurcation, kissing dilation was required in 33.3% of cases, and the transition to double-stent technique was required in 11.1% of cases (33.3% of cases where kissing dilation was performed (p=0.610)). With the initially affected lateral branch, kissing dilation was required in 88.2 % of cases, and stenting of the lateral branch was required in 47.1 % of cases (53.3% of cases where kissing dilation was performed). With an intact lateral branch, kissing dilation was required in 26.5 % of cases, the second stent was needed in 8.8 % of cases (33.3% of cases where kissing dilation was performed (p<0.001)). In the presence of a blood clot in the bifurcation area, the need for kissing dilation appeared in 75% of cases, and the need for double-stent technique – in 12.5% of cases (20% of cases where kissing dilation was performed).CONCLUSIONS. When using the Provisional techniques, the kissing dilation was required in 47.1 % of cases. Expansion of the scope of surgical intervention to double-stent technique was required in 21.6 % of cases.https://www.vestnik-grekova.ru/jour/article/view/2235bifurcation lesion of the coronary arteriessingle-stent techniquetwo-stent methodspredictors of doublestent technique
spellingShingle R. E. Kalinin
I. A. Suchkov
A. V. Karpov
I. B. Ilyasov
I. N. Shanaev
Reasons and frequency of transition to a double-stent technique when correcting bifurcation lesions of the coronary arteries in patients with acute coronary syndrome
Вестник хирургии имени И.И. Грекова
bifurcation lesion of the coronary arteries
single-stent technique
two-stent methods
predictors of doublestent technique
title Reasons and frequency of transition to a double-stent technique when correcting bifurcation lesions of the coronary arteries in patients with acute coronary syndrome
title_full Reasons and frequency of transition to a double-stent technique when correcting bifurcation lesions of the coronary arteries in patients with acute coronary syndrome
title_fullStr Reasons and frequency of transition to a double-stent technique when correcting bifurcation lesions of the coronary arteries in patients with acute coronary syndrome
title_full_unstemmed Reasons and frequency of transition to a double-stent technique when correcting bifurcation lesions of the coronary arteries in patients with acute coronary syndrome
title_short Reasons and frequency of transition to a double-stent technique when correcting bifurcation lesions of the coronary arteries in patients with acute coronary syndrome
title_sort reasons and frequency of transition to a double stent technique when correcting bifurcation lesions of the coronary arteries in patients with acute coronary syndrome
topic bifurcation lesion of the coronary arteries
single-stent technique
two-stent methods
predictors of doublestent technique
url https://www.vestnik-grekova.ru/jour/article/view/2235
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