Ángulo de bifurcación corregido versus ángulo de bifurcación distal para la predicción de la rama lateral. Compromiso después de la bifurcación provisional Intervención Coronaria
Corrected Bifurcation Angle versus Distal Bifurcation Angle for Prediction of Side Branch Compromise after Provisional Bifurcation Coronary Intervention
Prensa méd. argent; 106 (5), 2020
Publication year: 2020
Provisional bifurcation percutaneous coronary intervention (PCI) is recommended over two stent strategy but with the risk of side branch (SB) compromise. Prediction SB compromise is crucial for optimizing of the procedure outcome. Neglecting the proximal bifurcation angle (BA), the distal BA was
presented as a reliable predictor of SB compromise supposing that the main vessel is always a straight
vessel. However, its impact on the fate of side branch is debated. This study aims to compare between
of the corrected BA, the sum of proximal and distal BAs, and the distal BA in terms of prediction of
SB compromise. This prospective cohort study was conducted in Zagazig university hospitals in the
duration between March 2019 and March 2020, and involved 185 patients who underwent provisional
bifurcation PCI. Patients were divided according to the corrected BA into two groups; straight bifurcation model group which involved 73 patients with corrected BA = 180º, and wide bifurcation model
group which involved 112 patients with corrected BA > 180 º. Compared to the wide bifurcation model,
the incidence of SB compromise was substantially higher in the straight bifurcation model (52.1% vs.
15.2%; P < 0.001). The corrected BA had a better area under the curve compared to the distal BA with
statistically significant difference (0.711 vs. 0.580; P = 0.023). Multivariate analysis demonstrated that
the corrected BA was among the independent predictors of SB compromise. The study concluded that
the corrected BA could be a novel strong predictor of SB compromise after provisional bifurcation PCI
for future verification.