1. Main branch restenosis at 1 year
DKCRUSH-VI
Trial design: Patients with Medina 1,1,1 and 0,1,1 coronary bifurcation lesions undergoing stenting with a provisional side branch (SB) approach were randomly assigned in a 1:1 fashion to angiography-guided or FFR-guided groups. Patients were followed for 1 year.
Results
(p = 0.01)
Side branch stenting in angiography vs. FFR arms: 38.1% vs. 25.9% (p = 0.01)
In-segment restenosis in distal main vessel: 9.2% vs. 1.7%, p = 0.01; side branch vessel restenosis: 21.2% vs. 11.8%, p = 0.037
MACE: 18.1% vs. 18.1%, p = 1.0; MI: 13.8% vs. 11.9%, p = 0.74; TLR: 5.0% vs. 3.1%, p = 0.57; stent thrombosis: 1.3% vs. 0.6%, p > 0.05 %
Conclusions
FFR-guided strategy results in fewer stents and less angiographic restenosis than an angiography alone strategy in true bifurcation lesions where a provisional SB approach is pursued
Clinical outcomes at 1 year were similar
Appears to be a reasonable approach to ↓ stenting due to occulostenotic reflex in bifurcation lesions
Main branch restenosis at 1 year
Angiography-guided
(n = 160)
FFR-
guided
(n = 160)
Presented by Dr. Shao Liang Chen at TCT 2014