Iranian Heart Journal

Iranian Heart Journal

Major Adverse Cardiovascular Events in Stenting Bifurcated Coronary Lesions: A Comparative Cross-Sectional Study of Provisional and Double-Stenting Methods

Document Type : Original Article

Authors
Seyed Aboozar Fakhr Mousavi 1
Arsalan Salari 1
Aseme Pourrajabi 1
Fardin Mirbolouk 1
Sanaz Kalavari 1
Samaneh Karami 2
Salman Nikfarjam 1
Seyed Mehdi Mousavi 1
1 Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IR Iran.
2 Cardiovascular Diseases Research Center, Department of English, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, IR Iran.
Abstract
Background: A coronary bifurcation lesion is defined as a stenosis located at the origin of a significant side branch. While the provisional approach is recognized as the gold standard, the two-stent strategy is proposed as a viable alternative. This study aimed to compare the incidence of major adverse cardiac events (MACE) between the provisional and double-stenting techniques.
 
Methods: A total of 280 patients with stenosis at the bifurcation of the coronary arteries were enrolled in the study. The variables examined included the location of the lesion in the coronary arteries, the extent of the coronary artery lesion, the treatment strategy (either double stenting or provisional stenting), and the incidence of MACE. Patients were followed up at 6 months and 1 year after angioplasty. Data were analyzed using SPSS software to compare the frequency of MACE between the 2 groups. A significance level of P < 0.05 was considered.
 
Results: Of the 280 participants, 219 were assigned to the provisional group, while the remaining participants were in the double-stenting group. A comparison of the 2 groups regarding vessel involvement and lesion site classification revealed that the highest frequency (75%) was associated with the left anterior descending artery and the diagonal branches. The most common complication observed during the first follow-up was recurrent angioplasty, occurring in 10.71% of participants. Additionally, 33.33% of the total participants in both groups underwent target vessel revascularization 1 year after angioplasty.
 
Conclusions: There was no significant difference in the occurrence of MACE between the provisional and double-stenting methods for treating coronary bifurcation lesions. (Iranian Heart Journal 2025; 26(2): 15-22)
Keywords
Major adverse cardiovascular events
Bifurcated coronary lesions
Provisional stenting method
Double-stenting method
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Iranian Heart Journal
Volume 26, Issue 2
Spring 2025
Pages 15-22