Clinical research

DOI: 10.4244/EIJ-D-23-00211

Stepwise provisional versus systematic culotte for stenting of true coronary bifurcation lesions: five-year follow-up of the multicentre randomised EBC TWO Trial

Sandeep Arunothayaraj1, MBBS; Miles W. Behan2, DM, FRCP; Thierry Lefèvre3, MD; Jens F. Lassen4, MD; Alaide Chieffo5, MD; Goran Stankovic6, MD; Francesco Burzotta7, MD; Manuel Pan8, MD; Miroslaw Ferenc9, MD; Thomas Hovasse3, MD; Mark S. Spence10, MD; Philippe Brunel11, MD; James M. Cotton12, MD; James Cockburn1, MD; Didier Carrié13, PhD; Andreas Baumbach14, MD; Michael Maeng15, MD; Yves Louvard3, MD; David Hildick-Smith1, MD

Abstract

Background: The multicentre European Bifurcation Club Trial (EBC TWO) showed no significant differences in 12-month clinical outcomes between patients randomised to a provisional stenting strategy or systematic culotte stenting in non-left main true bifurcations.

Aims: This study aimed to investigate the 5-year clinical results of the EBC TWO Trial.

Methods: A total of 200 patients undergoing stent implantation for non-left main bifurcation lesions were recruited into EBC TWO. Inclusion criteria required a side branch diameter ≥2.5 mm and side branch lesion length >5 mm. Five-year follow-up was completed for 197 patients. The primary endpoint was the composite of all-cause mortality, myocardial infarction, or target vessel revascularisation.

Results: The mean side branch stent diameter was 2.7±0.3 mm and mean side branch lesion length was 10.3±7.2 mm. At 5-year follow-up, the primary endpoint occurred in 18.4% of provisional and 23.7% of systematic culotte patients (hazard ratio [HR] 0.75, 95% confidence interval [CI]: 0.41-1.38). No significant differences were identified individually for all-cause mortality (7.8% vs 7.2%, HR 1.11, 95% CI: 0.40-3.05), myocardial infarction (8.7% vs 13.4%, HR 0.64, 95% CI: 0.27-1.50) or...

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Volume 19 Number 4
Jul 17, 2023
Volume 19 Number 4
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