Coronary Artery Disease Clinical Trial
Official title:
Prospective, Randomized, Single-Center Evaluation of the Cypher™ Sirolimus Eluting Coronary Stent System in the Treatment of Bifurcated Coronary Lesions
This study is a prospective, randomized, single-center evaluation of the Cypher™ Sirolimus eluting coronary stent system in the treatment of de novo bifurcated coronary lesions comparing provisional modified T stenting with systematic modified T-stenting.
Bifurcations involving a significant side branch (SB diameter ≥ 2.25 mm) occur in
approximately 15-20% of all coronary lesions considered for percutaneous intervention. If a
side branch (SB) subtends significant myocardium, failure to preserve SB vessel patency can
lead to complications such as myocardial infarction or persistent chest pain despite full
patency of the main branch.
Bifurcation lesions are inherently complex and interventional treatment remains a
challenging problem for physicians.
The optimal technique for stenting bifurcated lesions is still unknown. Several dual vessel
stenting techniques have been described in the literature, such as "T", "V", "Y", "Culotte"
and "Crush" procedures. However, most studies of bifurcation stenting have found that
optimal long-term results are obtained by stenting the main vessel and then performing plain
balloon angioplasty of the side branch ("kissing balloon"-technique). Nevertheless,
occlusion or reduced flow of the SB are frequent after stenting of the MB. Therefore, the SB
is stented in approximately 50% of procedures even if PTCA alone was intended.
Hypothesis:
Compared with plain dilatation of side branch, the placement of Cypher-Stent in side branch
using modified T-stenting technique will reduce "in-segment percent diameter stenosis" of
the side branch at 9 months post procedure as measured by quantitative coronary angiography.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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