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Long-term outcomes after percutaneous revascularization of complex coronary bifurcation lesions using a dedicated self-expanding biolimus-eluting stent system.

Long-term outcomes after percutaneous revascularization of complex coronary bifurcation lesions using a dedicated self-expanding biolimus-eluting stent system.
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Triantafyllis AS, Bennett J, Pagourelias E, McCutcheon K, Adriaenssens T, Sinnaeve PR, Desmet W, Dubois C,


Triantafyllis AS, Bennett J, Pagourelias E, McCutcheon K, Adriaenssens T, Sinnaeve PR, Desmet W, Dubois C, (click to view)

Triantafyllis AS, Bennett J, Pagourelias E, McCutcheon K, Adriaenssens T, Sinnaeve PR, Desmet W, Dubois C,

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Cardiology journal 2017 12 14() doi 10.5603/CJ.a2017.0141
Abstract
BACKGROUND
To evaluate long-term clinical outcomes after treatment of complex bifurcation lesions with the AXXESS dedicated self-expanding biolimus A9-eluting bifurcation stent.

METHODS
Between 2004 and 2013, 123 patients with complex bifurcation lesions were treated in a single center with the AXXESS stent in the proximal main vessel (MV) and additional drug-eluting stents in branches when required. Median follow-up was 5 years. Primary endpoint was the rate of major adverse cardiac events (MACE). Secondary endpoints included MACE components (cardiac death, non-periprocedural clinical myocardial infarction [MI], target lesion revascularization [TLR] and definite/probable stent thrombosis [ST]) as well as all-cause death, target vessel revascularization (TVR) and non-TVR.

RESULTS
During follow-up, 11 (8.9%) patients experienced a MACE, of whom 2 (1.6%) suffered cardiac death, 2 (1.6%) had a non-periprocedural clinical MI requiring TLR, and 7 (5.7%) underwent elective TLR. No definite/probable ST was observed. All-cause death occurred in 9 (7.3%) patients, TVR in 11 (8.9%) and non-TVR in 11 (8.9%). Patients treated for left main (LM) bifurcation lesions were more likely to experience MACE than non-LM bifurcation lesions (25% vs. 6.5%, p = 0.04).

CONCLUSIONS
Percutaneous revascularization of complex bifurcation lesions with the AXXESS stent is safe and provides excellent long-term results, especially in non-LM lesions.

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