The long-term clinical outcome of T-stenting and small protrusion technique for coronary bifurcation lesions

JACC Cardiovasc Interv. 2013 Jun;6(6):554-61. doi: 10.1016/j.jcin.2013.01.137. Epub 2013 May 15.

Abstract

Objectives: This study sought to report long-term clinical outcomes in patients treated with the provisional T-stenting and small protrusion (TAP) technique.

Background: Several strategies have been proposed for treating bifurcation lesions, each with its own merits and technical challenges. The TAP technique is a relatively new strategy that is technically less challenging, ensures complete coverage of the side-branch ostium, and minimizes stent overlap. Although there is reasonable amount of data for other bifurcation strategies, the long-term clinical outcomes for TAP technique are limited.

Methods: We retrospectively evaluated all patients who underwent TAP technique with drug-eluting stents between July 2005 and January 2012. The measured endpoints at follow-up were major adverse cardiac events defined as composite of cardiac death, myocardial infarction, and target vessel revascularization.

Results: A total of 95 patients (81.1% men) with a mean age of 64.8 years underwent TAP stenting. Procedural success was achieved in 100% of cases. True bifurcation was observed in 75 (78.9%) patients. First-generation drug-eluting stents were used in 55.8% of patients. The outcome rates at 3-year follow-up of major adverse cardiac events, cardiac death/follow-up myocardial infarction, target vessel revascularization, and target lesion revascularization were 12.9%, 3.1%, 9.7%, and 5.1%, respectively. There were no cases of follow-up myocardial infarction or stent thrombosis (definite and probable).

Conclusions: These results demonstrate that TAP technique is associated with acceptable clinical outcomes with no episodes of definite and probable stent thrombosis. Further studies should compare TAP technique with other 2-stent strategies.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Coronary Angiography
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / therapy*
  • Coronary Thrombosis / etiology
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Percutaneous Coronary Intervention / methods*
  • Percutaneous Coronary Intervention / mortality
  • Prosthesis Design
  • Retrospective Studies
  • Stents*
  • Time Factors
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Ultrasonography, Interventional