Meta-Analysis Comparing Outcomes With Bifurcation Percutaneous Coronary Intervention Techniques
Section snippets
Methods
A computerized search of Medline, Scopus, and Cochrane databases was performed without language restriction through January 2021, using the terms “percutaneous coronary intervention,” “PCI” and “bifurcation” separately and in combination to identify randomized clinical trials that evaluated the outcomes of various bifurcation PCI techniques. We screened the bibliographies of the retrieved studies and ClinicalTrials.gov to identify any relevant studies not retrieved through the initial search.
Results
The study selection process is outlined in Figure 1. The final analysis included 22 randomized studies with a total of 6,359 patients.4,5,7,12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 The included studies analyzed the following bifurcation techniques: PS (n = 2,171), T/TAP (n = 497), crush (n = 905), culotte (n = 873), DK-crush (n = 851) and group with mixed 2-stent bifurcation techniques (n = 1,062) (Supplementary Table 1). The weighted mean follow-up was
Discussion
In this meta-analysis of 22 randomized clinical trials including 6,735 patients, we evaluated the efficacy and safety of various bifurcation PCI techniques. The principal findings of this analysis were: (1) there was no significant difference between 1-stent versus 2-stent approaches in MACE, all-cause mortality, cardiovascular mortality, acute MI, TVR, TLR, and stent thrombosis at a mean follow-up of ∼26 months; (2) exploratory analysis suggested a higher risk of MACE with 1-stent compared
Disclosures
Dr. Latib is a consultant and/or on the advisory board of Medtronic, Abbott, Boston Scientific, and Philips. Dr. Elgendy has disclosures unrelated to this manuscript content including receiving research grants from Caladrius Biosciences, Inc. Dr. Abbott is a consultant for Philips and Boston Scientific and has research funding from Abbott, Biosensors, and Sinomed. The other authors have no conflicts of interest to declare.
Funding
None.
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